Zalewski et al reported criteria for the diagnosis of spontaneous spinal cord infarction. The authors are from the Mayo Clinic.
The patient develops an acute nontraumatic myelopathy with:
(1) rapid progression over 12 hours or less (time between onset and nadir). There may be a stuttering course beforehand, but any sudden deterioration should be rapid.
(2) show severe acute motor and/or sensory deficits. There is usually the loss of antigravity strength. Sensory loss may be disabling.
Criteria:
(1) presence of acute nontraumatic myelopathy without preceding progressive myelopathy
(2) no spinal cord compression on MRI
(3) intramedullary T2 hypertense spinal cord lesion on MRI (supportive)
(4) vertebral body infarction and/or arterial dissection/occlusion adjacent to lesion in diffusion weighted imaging
(5) CSF noninflammatory (normal cell count; normal IgG index; no oligoclonal bands)
(6) no more likely alternative diagnosis
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Diagnosis
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Pattern of Criteria
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definite spontaneous
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1, 2, 3, 4. 6
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probable spontaneous
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1, 2, 3, 5, 6
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possible spontaneous
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1 and 6
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definite periprocedural
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1, 2, 3, 6
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probable periprocedural
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1 and 6
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For the diagnosis to be periprocedural there would presumably have to be a procedure at the time, which could be a seventh item.
