The anterior spinal artery syndrome refers to neurologic findings associated with ischemia of structures in the distribution of the anterior spinal artery.

Precipitating factors are varied and include:

(1) thromboemboli from heart, aorta or other sites

(2) hypotension or poor perfusion

(3) infection (including syphilis, sepsis)

(4) vaccination

(5) spinal cord angioma

(6) metastatic cancer

(7) dorsolumbar sympathectomy

(8) cervical spondylosis

(9) vertebral angiogram

(10) physical exertion

(11) hypercoagulability

(12) disorders of the aorta (dissection, etc)

(13) traumatic disk herniation

(14) epidural anesthesia

(15) idiopathic


Clinical findings:

(1) partial or complete motor loss below the level of injury

(2) partial or complete loss of pain sensation below the level of injury

(3) partial or complete loss of temperature sensation below the level of injury

(4) relative sparing of proprioception, vibratory sensation and touch


MRI of the spinal cord shows the owl eye sign (antero-central T2-weighted hyperintensity).


Most patients recover some or all function.


A few patients may have a recurrence.


Sparing of motor function or pain sensation below the lesion do better than those without both findings.

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