Paediatric spinal cord infarction—a review of the literature and two case reports

Childs Nerv Syst, 2017 · DOI: 10.1007/s00381-016-3295-8 · Published: November 26, 2016

Simple Explanation

Spinal cord infarction, where the spinal cord doesn't get enough blood, is rare in children. It can lead to lasting problems and the need for ongoing care. The authors present two cases of ischemic spinal cord infarction in children, one following surgery and another after a minor fall. Early diagnosis using MRI is important, but it can be challenging to distinguish spinal cord infarction from other conditions like myelitis.

Study Duration

Not specified

Participants

Two case reports of children

Evidence Level

Level 4: Case reports and literature review

Key Findings

1
The first case showed spinal cord infarction following calvarial remodeling surgery, possibly due to a combination of mild traction and flexion on the cervical spine.
2
The second case demonstrated that spinal cord infarction can occur after mild trauma, highlighting the limited understanding of these rare events.
3
Diffusion-weighted MRI can identify ischemic insult within hours of the event, aiding in early diagnosis.

Research Summary

Ischemic spinal cord infarction is rare in the pediatric population and often associated with trauma, congenital cardiovascular malformations, or thromboembolic disease. The outcome is variable and depends on the level and extent of the spinal cord infarct and subsequent rehabilitation. Two cases of ischemic spinal cord infarction in children are presented: one following calvarial remodeling surgery and another after a minor fall.

Practical Implications

Increased Awareness

Clinicians should maintain a high level of suspicion for spinal cord infarction in children, even after seemingly trivial trauma.

Surgical Positioning

Careful attention to surgical positioning and support of the cervical spine is crucial during calvarial remodeling procedures.

Early Diagnosis

Utilizing diffusion-weighted MRI can aid in early diagnosis and intervention for suspected spinal cord infarction.

Study Limitations

1
The underlying cause in many children presenting with acute spinal cord infarction remains unclear.
2
Spinal vessels are too small to resolve on standard imaging, hindering the identification of pre-existing vascular anomalies.
3
Movement and CSF flow artefacts and the relatively smaller cross-sectional area available for examination can limit MRI examination in children.

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