Myelomalacia acute ischemic

Fig. 17.4. Axial T2-weighted images in four patients with acute ischemic myelomalacia of the spinal cord. The hyperin-tense infarctions reflect different lesion patterns depending on occlusion site and collateral supply...

Compared with brain ischemia spinal cord strokes are caused by more diverse etiologies. Up-to-now there is no satisfactory and accepted classification of spinal infarcts. Etiologies include circulatory arterial and venous disorders. From a clinical and pathoanatomical point of view it seems reasonable to differentiate between acute ischemic myelomalacia and subacute to chronic vascular myelopathy (Table 17.1). In most cases MRI enables the differentiation of these two main etiologies. A deficient spinal arterial blood flow generally has various causes, ranging from the occlusion of intercostal or lumbar arteries to affection of the intrinsic arteries of the spinal cord. ... 

Acute ischemic myelomalacia of arterial and venous origin... 

Fig. 17.7. Acute ischemic myelomalacia of the thoracolumbar region in two patients, T2-weighted MR images. The pencilshaped zone of increased signal represents the acute infarcted cord...

Fig. 17.8a,b. Acute ischemic myelomalacia of the lumbar enlargement 3 weeks after onset of symptoms. Contrast-enhanced Tl-weighted images in sagittal and axial orientation at different levels, a Enhancement of the ventral cauda equina (arrow, arrowhead), b Peripheral ring-like enhancement of the affected lumbar enlargement (arrow, arrowhead)... 

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