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Thread: Long-Term Outcome of Acute Spinal Cord Ischemia Syndrome

  1. #1

    Long-Term Outcome of Acute Spinal Cord Ischemia Syndrome

    This is an excellent review. You can go to the following site and download the full paper. It is worth reading. Please note the final sentence of the abstrac.

    http://stroke.ahajournals.org/cgi/co...tract/35/2/560

    Long-Term Outcome of Acute Spinal Cord Ischemia Syndrome

    Krassen Nedeltchev, MD; Thomas J. Loher, MD; Frank Stepper, MD; Marcel Arnold, MD; Gerhard Schroth, MD; Heinrich P. Mattle, MD; Matthias Sturzenegger, MD
    From the Departments of Neurology (K.N., T.J.L., F.S., M.A., H.P.M., M.S.) and Neuroradiology (G.S.), University Hospital of Bern, Inselspital, Bern, Switzerland.


    Correspondence to Matthias Sturzenegger, MD, Department of Neurology, University of Bern, Inselspital, 3010 Bern, Switzerland. E-mail Matthias.Sturzenegger@insel.ch

    Background and Purpose— Current knowledge of long-term outcome in patients with acute spinal cord ischemia syndrome (ASCIS) is based on few studies with small sample sizes and <2 years’ follow-up. Therefore, we analyzed clinical features and outcome of all types of ASCIS to define predictors of recovery.

    Methods— From January 1990 through October 2002, 57 patients with ASCIS were admitted to our center. Follow-up data were available for 54. Neurological syndrome and initial degree of impairment were defined according to American Spinal Injury Association (ASIA)/International Medical Society of Paraplegia criteria. Functional outcome was assessed by walking ability and bladder control.

    Results— Mean age was 59.4 years; 29 were women; and mean follow-up was 4.5 years. The origin was atherosclerosis in 33.3%, aortic pathology in 15.8%, degenerative spine disease in 15.8%, cardiac embolism in 3.5%, systemic hypotension in 1.8%, epidural anesthesia in 1.8%, and cryptogenic in 28%. The initial motor deficit was severe in 30% (ASIA grades A and B), moderate in 28% (ASIA C), and mild in 42% (ASIA D). At follow-up, 41% had regained full walking ability, 30% were able to walk with aids, 20% were wheelchair bound, and 9% had died. Severe initial impairment (ASIA A and B) and female sex were independent predictors of unfavorable outcome (P=0.012 and P=0.043).

    Conclusions— Considering a broad spectrum of clinical presentations and origins, the outcome in our study was more favorable than in previous studies reporting on ASCIS subgroups with more severe initial deficits.

  2. #2
    Super Moderator Sue Pendleton's Avatar
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    Wise, Under Laboratory Findings there is no table or outcome discussed of the different findings in the CSF done on the patients. Does this mean viral infection of the spinal fluid is not an indicator of cause or not a predictor of outcome?
    Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

    Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied and are based solely on my experiences as a SCI patient. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

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