What is Spinal Stroke?
QI Spine Clinic, 2 weeks ago
Your spinal cord, just like your brain, is a key part of your central nervous system. It needs a constant blood supply to work aptly. A spinal stroke occurs when blood can’t reach your spinal cord. Doctors also call this spinal ischemia or spinal cord infarction. It’s not common, but it’s a serious condition. It can lead to nerve-related problems and might cause major disability down the line.
What is a Spinal Stroke?
A spinal stroke is a form of stroke caused due to decreased blood flow to the spinal cord. Whenever the arteries which supply the spinal cords get blocked due to a blood clot, the spinal tissues and cells get destroyed, resulting in an ischemic spinal stroke. A hemorrhagic spinal stroke occurs because of bleeding. Though very rare, it accounts for only 1 per cent of all strokes. In the event that a spinal stroke is caused, it may mean long-term complications of health, paralysis, or even at times, it can mean death when one fails to seek medical attention immediately.
Spinal Stroke Causes
Most of the spinal strokes occur due to changes in the structure of the blood vessels. For example, the blood vessel walls may thicken which may result in the blood vessel becoming narrow; often as a part of the natural aging process.
Several specific factors can significantly elevate the risk of these changes, including:
- High cholesterol
- Hypertension (high blood pressure)
- Heart disease or a family history of heart disease
- Obesity
- Trauma
- Diabetes
- Smoking
- Excessive alcohol intake
- Sedentary lifestyle
These risk factors put an extra burden on the heart to pump blood and make it a lot more probable for the blood vessels to become narrowed or are not likely to function properly. For instance, high blood pressure weakens blood vessels and makes them fragile and more vulnerable to rupture and bleeding, potentially leading to a stroke. Other less common spinal stroke causes include abnormally tangled blood vessels called arteriovenous malformations (AVMs), spinal tuberculosis, spinal cord compression, cauda equina syndrome (CES) and secondary spinal tumours. There is also an increased risk of spinal stroke after abdominal surgery.
Spinal Stroke Symptoms
The signs of a spinal stroke depend on what region of the spinal cord has been affected and how much of the cord has been injured. The symptoms usually appear suddenly, but sometimes they might appear a few hours after a stroke.
Common spinal stroke symptoms include:
- Sudden, Severe Back Pain
- Muscle weakness in the legs
- Muscle spasms
- Breathing difficulties
- Numbness, tingling, or loss of sensation
- Problems with bladder and bowel control (incontinence)
- Paralysis
- Unable to detect cold or heat
- Tightness or pain in your chest
- Severe spinal stroke instances can result in death.
Spinal Stroke Treatment
Spinal stroke treatment is based on the precise cause of the spinal stroke, coupled with symptom severity and degree of damage.
Medication options may include:
- Blood-thinning medications like warfarin or aspirin dissolve blood clots that might be blocking the arteries and prevent new ones from forming.
- Medications that can effectively handle issues that can result from a stroke include muscle stiffness, bladder or bowel incontinence, and sexual health problems.
- Medications to keep blood pressure and cholesterol under control, hence reducing the additional risks.
In emergency situations, surgical intervention may be needed to remove blood clots from arteries or veins through what is called surgical thrombectomy. It involves a surgeon making an incision near the blocked vessel to extract the clot. Another approach is the insertion of a small balloon-like device that holds the vessel open to continue blood flow.
The physical and occupational therapies seem to be effective in regaining function and independence in cases of long-term muscle weakness or paralysis. If an issue arises in passing, such as difficulty passing urine, then a catheter use may be necessary. This is a flexible tube placed in the pelvic area through which one may facilitate the passage of urine and other liquids.
Complications of a Spinal Stroke
Complications vary based on the specific area of the spinal cord impacted. For instance, reduced blood flow to the front of the spinal cord can result in permanent paralysis of the legs.
- Potential complications include:
- Respiratory issues
- Persistent paralysis
- Incontinence of bowel and bladder
- Sexual dysfunction
- Neuropathic pain
- Pressure sores due to diminished sensation in affected regions
- Muscle tone abnormalities, such as spasticity (uncontrolled muscle tightness) or flaccidity (lack of muscle tone)
- Depression
Spinal Stroke Recovery
Recovery from a spinal stroke is long and tedious. Recovery depends mainly on the extent of the primary injury and, of course, the promptness of treatment. A very important part of spinal stroke recovery is rehabilitation, which includes various therapies and other interventions. These would include the following techniques:
- Physical Therapy: These techniques will help in muscle strengthening and improving mobility and coordination. Exercise, stretching, and the use of assistive devices characterize these techniques.
- Occupational Therapy: Assists patients in regaining their independence in terms of daily activities, mainly through the restoration of fine motor skills and an adaptation to new ways of performing tasks.
- Speech Therapy: If the stroke has affected a person’s speech or swallowing, speech therapy would be an effective method to regain such functions.
- Psychological Support: It is also necessary to overcome the various emotional and psychological difficulties that exist when suffering from a spinal stroke. Counseling and attending support groups may be useful.
There are several studies that show approximately 40-42 percent of patients have an improvement in symptoms following a stroke treatment. However, how much they recover can vary a lot from person to person.
Conclusion
A spinal stroke is a serious medical condition that calls for urgent attention and comprehensive care. The causes, symptoms, and modes of treatment are very important for effective management. Recovery from any form of spinal stroke depends on the multidisciplinary approach to its treatment, covering the continuum from medical care to rehabilitation and counselling support. Most patients with proper treatment and adequate rehabilitation have a symptomatic and functional improvement in their quality of life.
