A 45-year old male patient with diabetes presented neck pain with paresthesia and paresis in upper limbs. Physical examination: proximal paraparesis, hyporeflexia and hypoesthesia in the upper limbs. MRI: ischemia in the right hemi-spinal cord (Fig 1), associated to right vertebral artery (VA) dissection (Fig 2). Although more frequently VA dissection causes transient ischemic attack or stroke1...

This keynote lecture and corresponding presentation discuss the anatomy pathophysiology surrounding spinal cord injury in aortic surgery. article will risk factors mechanisms for injury, including loss of direct collateral perfusion ischemia-reperfusion injury. review examine these elements both laboratory clinical setting, addition to other neuroprotective strategies applied practice. Addressi...

In spinal cord injuries, direct trauma by edges of sublaxated or dislocated vertebrae and indirect ischemia as a result of vascular injury necrotize the neural tissue. After spinal cord injury, tissue loss appears as micro- or macrocavitation. Accumulations of non-neuronal cells substitute spared tissue and halts axon regrowth. Lack of supporting cells (secreting trophic factors and matrix) agg...

Ischemia/reperfusion (I/R) induced spinal cord injury is an important pathologic mechanism leading to the paraplegia observed after surgery to repairaortic aneurysms. This study aims to investigate the neuroprotective effects of Lipoxin A4 and its potential mechanism in a rabbit model with I/R spinal cord injury. Forty-five rabbits were randomly divided into three groups: sham group, I/R group ...

OBJECTIVE In the present study, we investigated the effect of ischemic pretreatment on heat shock protein 72 concentration and neurologic and histopathologic outcome after transient spinal cord ischemia. METHODS In 28 New Zealand White rabbits, an aortic occlusion device was placed infrarenally. The animals were randomly assigned to 2 groups: ischemic pretreatment (n = 14 animals) and control...

Populations of intrathoracic extracardiac neurons transduce myocardial ischemia, thereby contributing to sympathetic control of regional cardiac indices during such pathology. Our objective was to determine whether electrical neuromodulation using spinal cord stimulation (SCS) modulates such local reflex control. In 10 anesthetized canines, middle cervical ganglion neurons were identified that ...

OBJECTIVES To evaluate the effectiveness of acute ischemic preconditioning (IP), based on somatosensory evoked potentials (SSEP) monitoring, as a method of spinal cord protection and to asses SSEP importance in spinal cord neuromonitoring. METHODS Twenty-eight dogs were submitted to spinal cord ischemic injury attained by descending thoracic aorta cross-clamping. In the C45 group, the aortic ...

BACKGROUND The thoracic or thoracoabdominal aortic aneurysm surgery may cause spinal cord ischemia because of aortic cross-clamping and may result in severe postoperative complications caused by spinal cord injury. Ischemia/reperfusion injury may directly or indirectly be responsible for these complications. In this study we sought to determine whether combination of iloprost and montelukast ca...

Three patients with spinal dural arteriovenous fistula presented with acute and/or progressive myelopathy. The thoracic cord was focally enlarged and poorly defined on MR images in two of the patients. One individual showed focal cord atrophy, and one demonstrated abnormal intrathecal vessels. In all patients MR studies revealed cord enhancement after IV administration of gadopentetate dimeglum...