Spinal cord vascular disease is rare but can be devastating to patients. Hypotension, especially in association with vascular procedures, and embolism are common causes of cord ischemia. Ischemia generally presents with acute painful myelopathy. The enclosed space of the spinal canal also renders the cord vulnerable to compressive effects of space-occupying vascular lesions, such as the dilated veins associated with vascular malformations. These are more likely to present with progressive myelopathy. MRI is the imaging modality of choice in identifying the cause and extent of vascular myelopathy. Interventional endovascular approaches to spinal vascular malformations are becoming more common.
Relationship Disclosure: Dr Geldmacher has received personal compensation for activities with Eisai Inc./Pfizer Inc, Forest Pharmaceuticals, Inc., Medical Care Corporation, Novartis Pharmaceuticals, Inc., and Takeda Pharmaceuticals, Inc. Dr Geldmacher has received grant or research support from Eisai Inc., Elan Pharmaceuticals, Inc., Myriad Pharmaceuticals, Inc., and GlaxoSmithKline. Dr Shah has nothing to disclose.
Unlabeled Use of Products/Investigational Use Disclosure: Drs Geldmacher and Shah have nothing to disclose.