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Query: UMLS:C0022116 (ischemia)
 91,303 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Diagnosis of myelopathies of vascular origin is difficult and they are probably underdiagnosed at this time because of the lack of diagnostic tools. A recent report of a 58 year old patient who developed ASAS after an episode of cardiac arrest pointed out the importance of MRI and somatosensory evoked potentials (SEP) to support the diagnosis. MRI with T2 weighted imaging demonstrated diffuse signal abnormalities in both gray matter and surrounding white matter below T7. Furthermore, SEP latencies showed a delay between T6 and T7. Therefore, new technologies including MRI and SEP may improve the diagnosis of spinal cord ischemic injuries. A brief discussion of the normal blood supply of the human spinal cord is presented in this review followed by new, pathophysiologically based classifications of the clinical syndromes of vascular myelopathies. A complete description of the clinical syndromes related to vascular myelopathies is included. Vascular myelopathies were divided into acute and chronic syndromes depending on the time at which the pathophysiological events take place. Subsequently, the two major groups of vascular myelopathies were divided depending on the type of vascular damage, e.g., arterial, venous and/or mixed origin. Posttraumatic spinal cord ischemia is included in the present classification because it is generally considered to be a significant factor contributing to secondary damage following blunt trauma. Since several new diagnostic techniques are now available to characterize the pathology of spinal cord injury, physicians involved in the diagnosis and treatment of vascular myelopathies may find the new classification useful in correlating clinical presentation with subjacent pathology. Identification of the correct pathology should result in more accurate treatment approaches.
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PMID:Pathophysiological classification of human spinal cord ischemia. 909 61

Acute nontraumatic myelopathies of childhood include inflammatory, infectious, and vascular etiologies. Inflammatory immune-mediated disorders of the spinal cord can be categorized as idiopathic isolated transverse myelitis, neuromyelitis optica, and multiple sclerosis. In recent years, human T-cell lymphotropic virus type 1, West Nile virus, enterovirus-71, and Lyme disease have been increasingly recognized as infectious etiologies of myelopathy, and poliomyelitis remains an important etiology in world regions where vaccination programs have not been universally available. Vascular etiologies include vasculopathies (systemic lupus erythematosus, small vessel primary angiitis of the central nervous system), arteriovenous malformations, and spinal cord infarction (fibrocartilaginous embolism, diffuse hypoxic ischemia-mediated infarction). Vascular myelopathies are less common than inflammatory and infectious myelopathies, but are more likely to lead to devastating clinical deficits. Current therapeutic strategies include acute anti-inflammatory treatment and rehabilitation. Stem cell transplantation, nerve graft implantation, and stimulation of endogenous repair mechanisms represent promising strategies for spinal cord repair.
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PMID:Inflammatory, vascular, and infectious myelopathies in children. 2362 8