Here’s an important topic.
I’m going to slow down
here just a little bit
because I want us to
be clear about things.
Anterior spinal artery syndrome.
Think about where you are.
So this is spinal cord.
First and foremost, do not confuse
this with anterior cerebral artery,
either on your boards
or on your wards.
It has nothing to do with
the brain right now.
So think about where the
anterior spinal artery is.
It’s located anteriorly,
obviously, in the spinal cord
and pretty much taking care of the
motor aspect of the spinal cord.
Is that clear?
Granted it’s rare but, oh my goodness,
you must be familiar with it and
you’ll see why even more so
as we continue this because
I need to give you
more information that is extremely
current for your understanding.
As you move anterior spinal artery all
the way from the rostral to the caudal,
Can you picture that?
So, from the head and down
towards the lower extremity.
You are going to get to a point
of approximately T8.
And at the level of T8, it’s
interesting because now,
I want you to think about the spinal cord
and think about what’s anterior to it,
and I’m going to bring to your attention a
structure called the abdominal aorta, okay?
So, where are you right now?
Level of T8.
Why am I bringing this up?
You’ll see in a second.
And anterior to the spinal cord
would be the abdominal aorta.
There are branches of that abdominal aorta,
which we then refer to as being
arteries of Adamkiewicz.
Once again, when you talk
about spinal cord anatomy,
be familiar with some of the vascular
supply, especially at the level of T8,
and specifically, this is
called artery of Adamkiewicz.
I want to expand upon this in a second.
At this point, if you’re unfamiliar,
please make sure that in anatomy,
you refer to your vascular supply.
Now, there’s infarction, could, of
anterior two-thirds of the cord.
So if there is anterior
spinal artery occlusion,
as rare as it may be,
think about what part of
spinal cord has been affected.
Obviously, the anterior portion,
about two-thirds of it.
So quite a bit of the
So therefore, what kind of
tracts are we looking at?
Affects the spinothalamic,
And once again, what will it spare?
Why did I say once again?
Because if it’s syringomyelia or
central canal type of syndrome,
there also, the dorsal
column is spared.
Here, also, dorsal
column is spared.
Results in spastic paralysis and loss
of pain and temperature sensation
with intact joint positions
sense and vibration.
Because the dorsal column is spared,
but the pain and temperature would be
affected, as will be the motor functioning.
in particular vascular pathology,
this is actually a surgery
type of a situation
that I’m going to give you, and I’m going
to expand upon this artery of Adamkiewicz.
Have you had a chance
to refer to it yet?
and these are branches
of the abdominal aorta.
And if you did have anterior spinal
artery syndrome or occlusion only,
well, you would think that maybe perhaps --
you’ll notice here that there’s
nothing about incontinence.
Because if it’s a spinal
cord that’s being affected,
would you expect there to
be perhaps incontinence?
The reason that you don’t is
because around T8 and below,
think about where you are,
you can have collateral supply
to your spinal cord via
some of your branches of the abdominal
aorta called artery of Adamkiewicz.
I bring this to your attention
because in surgery,
you can have a patient that has
abdominal aortic aneurysm,
plus, anterior spinal artery syndrome
in which you’ve lost all
control of your spinal cord.
So, what do you think the patient
is going to present with?
Here is an anterior spinal
artery syndrome, plus, triple A,
which then equals
If you have missed what I’ve said, I
know it’s a little bit complicated,
I’d recommend that you
listen to me a few times
so that all the information
that I’ve just given
is conceptually digested