Supplementary Material for: Characteristics of Spinal Cord Stroke in Clinical Neurology

Spinal cord stroke accounts for about 0.3% of all strokes in our department. Thirty-two patients (15 males, 17 females; mean age 63.3 years) treated in the period 1995–2010 were included. Patients underwent thorough investigation including the use of different stroke scales (National Institute of Health Stroke Scale, Barthel Index and modified Rankin Scale). Twenty-eight patients had infarctions, 3 had hemorrhages, and 1 had arterio-venous fistula. Twenty-eight spinal cord strokes were spontaneous, 2 were secondary to aorta aneurysms, and 2 post surgery. Biphasic ictus was seen in 17% of all spontaneous infarctions. Younger age, male gender, hypertension, diabetes mellitus, and higher blood glucose on admission regardless of diabetes mellitus, were risk factors associated with more severe spinal cord stroke. Treatment and prevention of these risk factors should be essential in spinal cord stroke. We recommend a clinical classification into upper (cervical) and lower (thoracic or medullary conus) spinal cord strokes. Patients with upper strokes in this study had more severe strokes initially, but they had a better prognosis. Therefore it is important to identify this patient group.Acute sensory spinal cord deficit symptoms, common initial symptoms in biphasic spinal cord strokes, should be considered as possible spinal cord stroke, especially when preceded by radiating pain between the shoulders.脊髓卒中在我科所有卒中病例中占比约0.3%。本研究纳入1995—2010年间收治的32例脊髓卒中患者，其中男性15例、女性17例，平均年龄63.3岁。所有患者均接受全面评估与检查，包括采用多种卒中专用量表：美国国立卫生研究院卒中量表（National Institute of Health Stroke Scale）、巴氏指数（Barthel Index）以及改良Rankin量表（modified Rankin Scale）。本队列中28例为脊髓梗死，3例为脊髓出血，1例为动静脉瘘（arterio-venous fistula）。28例脊髓卒中为原发性，2例继发于主动脉瘤，2例为术后继发性卒中。在所有原发性脊髓梗死病例中，17%表现为双相发作。年轻年龄、男性性别、高血压、糖尿病，以及无论是否合并糖尿病的入院时高血糖，均为与更严重脊髓卒中相关的危险因素。针对此类危险因素的干预与预防，应作为脊髓卒中临床诊疗的核心内容。我们建议将脊髓卒中按临床部位分为上颈段与下胸段或脊髓圆锥段两类。本研究中颈段脊髓卒中患者初始病情更为严重，但预后更佳，因此精准识别该类患者群体具有重要临床价值。急性感觉性脊髓缺损症状作为双相型脊髓卒中的常见首发表现，应被纳入脊髓卒中的鉴别诊断范围，尤其当症状前驱伴有肩背部放射痛时。