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• W2902923067 abstract "Objective: To describe the range of procedures associated with spinal cord infarction (SCI) as a complication of a medical/surgical procedure and define clinical and imaging characteristics that could be applied to help diagnose spontaneous SCI, where the diagnosis is often less secure. Background: SCI results in disabling neurologic deficits; although treatment options are limited, it is important to distinguish from other treatable causes of acute myelopathy. Given the often challenging diagnosis, it is possible that prior case series actually include patients with alternative etiologies of acute myelopathy. This limitation can be reduced by focusing on patients with SCI in the periprocedural setting. Design/Methods: We used an institution-based search tool to identify patients evaluated at Mayo Clinic, Rochester, MN from 1997–2016 with a periprocedural SCI. We performed a descriptive analysis of clinical features, MRI and other laboratory findings, and outcome. Results: Seventy-five patients were identified with SCI related to an invasive or non-invasive surgery including: aortic aneurysm repair (49%); other aortic surgery (15%); and a variety of other procedures (e.g., cardiac surgery, spinal decompression, epidural injection, angiography, nerve block, embolization, other vascular surgery, thoracic surgery) (36%). Deficits were maximal at first post-procedural evaluation in 61 patients (81%). Impaired dorsal column function was common on initial examination. Imaging features included owl eyes or anterior pencil sign on MRI (70%), but other T2-hyperintensity patterns were also seen. Gadolinium enhancement of the SCI and/or cauda equina were also common. Some cases demonstrated T2-hyperintensity of the anterior spinal artery, suggesting the presence of thrombus. Six patients (10%) had an initial normal MRI despite a severe deficit. Conclusions: SCI can occur as a complication of a variety of procedures other than those of the aorta. The characteristic clinical and radiologic findings that we describe with SCI may be used in future studies to help distinguish from alternate causes of acute myelopathy. Disclosure: Dr. Zalewski has nothing to disclose. Dr Rabinstein has nothing to disclose. Dr. Krecke has nothing to disclose. Dr. Brown has nothing to disclose. Dr Wijdicks has nothing to disclose. Dr. Weinshenker has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Novartis, Alexion, MedImmune, Caladrius Biosciences, Brainstorm Therapeutics. Dr. Doolittle has nothing to disclose. Dr Flanagan has nothing to disclose." @default.
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• W2902923067 date "2018-04-10" @default.
• W2902923067 modified "2023-09-27" @default.
• W2902923067 title "Spinal Cord Infarction: Clinical and Imaging Insights from the Periprocedural Setting (P3.246)" @default.
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