Emergency: requires immediate attention
Spinal cord infarction
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Synopsis

Signs and symptoms vary depending on the level of spinal cord involvement. Common symptoms include weakness and/or loss of sensation below the level of the infarction, urinary or stool incontinence, and neck or back pain. Infarctions in the cervical spinal cord can cause respiratory insufficiency, which is potentially life-threatening. Patients typically present acutely, with symptom onset over minutes to hours; however, symptoms may start gradually over several days and can be stuttering in onset.
Management includes supportive care. Cervical spinal cord infarctions can be life-threatening due to the potential for respiratory failure and autonomic instability. There is no standard therapy for spinal cord infarctions, and treatment depends on the suspected underlying cause of the infarction. Most patients will experience some neurological improvement; however, permanent leg weakness is common and up to one-third of patients need to use a wheelchair.
Codes
ICD10CM:G95.11 – Acute infarction of spinal cord
SNOMEDCT:
432249006 – Infarction of spinal cord
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Differential Diagnosis & Pitfalls
- Transverse myelitis
- Metabolic / toxic myelopathy (eg, subacute combined degeneration with vitamin B12 deficiency, copper deficiency)
- Multiple sclerosis
- Neuromyelitis optica
- Neurosarcoidosis (see sarcoidosis)
- Tabes dorsalis (neurosyphilis)
- Spinal infections (eg, West Nile virus, human T-cell lymphotropic virus, HIV)
- Vertebral osteomyelitis
- Aortic dissection
- Cervical spondylosis
- Spinal stenosis
- Spinal cord compression
- Spinal cord hemorrhage
- Spinal cord injury / trauma / fracture
- Spinal cord tumor
- Cauda equina syndrome
- Spinal arteriovenous malformations
- Dural arteriovenous fistulas
- Vasculitis
- Caisson disease (diver's decompression sickness)
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Last Reviewed:06/11/2019
Last Updated:10/29/2019
Last Updated:10/29/2019