Abstract
An analysis of 95 cases of paraplegia examined at post-mortem has been made to ascertain the pathological effects of circulatory disturbances occurring within the first month and in later stages.
The effects have been subdivided into those found on general autopsy and the ones revealed by detailed examination of the spinal cord.
In the acute stage pulmonary embolus was found in only five cases and was never a cause of death after the first month. Severe pulmonary oedema was a frequent finding in cases dying after cervical injury being present in 20 out of 30 cases dying in the first 11 days. The possible mechanisms in its production are discussed. Heart failure due to coronary thrombosis occurred in five cases in the late stage of paraplegia but this did not appear to be related in any way to the injury being in an age group when this was a common mishap.
In the spinal cord haemorrhage, contusion, compression and thrombosis were frequent occurrences. Vertebral artery occlusion was not a common finding in cervical injuries but when it did occur affected predominantly the brainstem and cerebellum. Occlusion of pial arteries or of intramedullary vessels was seen in 20 cases and was most likely to be found after fracture dislocations causing compression.
In the late stages haematomyelia, recanalisation of thrombosed arteries and thickening with hyalinisation of the walls of blood vessels in the cord remnant or its coverings were found.
Similar content being viewed by others
Article PDF
References
Antonini, A & Biancolani, A (1927). Arch Antrop. crim. 47, 747.
Baker, A B (1957) Neurology, 7, 743.
Blackwood, W (1958). In Greenfield, J. G., Blackwood, W., McMenemey, W. H., Meyer, A. & Norman, R. M. Neuropathology, chap. 2, p. 115. London: Arnold.
Borison, H L & Kovacs, B A (1959). J. Physiol. 145, 374.
Breithaupt, D J, Jousse, A T & Wynn-Jones, M (1961). Canad. med. Ass. J. 85, 73.
Brunn, F (1932) Wein. Klin. Wschr. 45, 1425.
Cameron, G R (1948) Brit. med. J. 1, 965
Cameron, G R & De, S N (1949). J. Path. Bact. 61, 375.
Cameron, & Sheikh, (1951).
Campbell, G S & Visscher, M B (1949). Amer. J. Physiol. 157, 130.
Campbell, G S, Haddy, F J, Adams, W L & Visscher, M B (1949). Amer. J. Physiol. 58, 98.
Cornil, H, Hamant, A & Mosinger, M (1930). Ann. Méd. 28, 453.
Dietrick, R B & RussI, S (1958). J. Amer. med. Ass. 166, 41.
Durbin, F C (1961) Proc. R. Soc. Med. 54, 367.
Elliot, A (1955) Acta med. scand. 150, 467.
Farber, S (1937) J. exp. Med. 66, 405.
Ford, F R & Clark, D (1956). Bull. Johns Hopk. Hosp. 98, 37.
Gamble, J E & Patton, H D (1953). Amer. J. Physiol. 172, 623.
Grinker, R & Guy, C (1927). J. Amer. med. Ass. 88, 1140.
Harrison, W & Liebow, A A (1952). Circulation, 6, 824.
Hess, L (1934) Wien. med. Wschr. 84, 285.
Horst, H G, Legler, H & Wegener, F (1950). Z. ges. exp. Med. 116, 179.
Hughes, J T (1964) Int. J. Paraplegia, 2, 2.
Jarisch, A, Richter, H & Thoma, H (1939). Klin. Wschr. 18, 1440.
Jellinger, K (1964) Acta neuropath. 3, 451.
Lord, K H & Bunts, R C (1956). J. Urol. 75, 66.
Maire, F W & Patton, H D (1956). Amer. J. Physiol. 184, 345.
Munro, D (1943) J. Amer. Med. Ass. 122, 1055.
Paine, R, Smith, J R & Howard, F A (1952). J. Amer. med. Ass. 149, 643.
Pratt-Thomas, H R & Berger, K E (1947). J. Amer. med. Ass. 133, 600.
Rech, R H, McCarthy, L E & Borison, H L (1962). Amer. J. Physiol. 203, 151.
Richards, P (1963) Brit. med. J. 2, 83.
Sarnoff, S J & Berglund, E (1952). Amer. J. Physiol. 70, 588.
Sarnoff, S J & Sarnoff, L C (1952). Circulation, 6, 51.
Schlesinger, B (1945). J. nerv. ment. Dis. 102, 247.
Schneider, R C, Thompson, J M & Bebin, J (1958). J. Neurol. Neurosurg. Psychiat. 21, 216.
Suechting, R L & French, L A (1955). J. Neurosurg. 12, 187.
Tribe, C R (1963) Int. J. Paraplegia, 1, 19.
Vincent, C & Bernard, E (1926). Bull. Soc. méd. Hop. Paris, 46, 1181.
Visscher, M B, Haddy, F J & Stephens, G (1956). Pharmacol. Rev. 8, 389.
Weisman, S J (1939). Surgery, 6, 722.
Wyburn-Mason, R (1943) The Vascular Abnormalities and Tumours of the Spinal Cord and its Membranes, chap. 3, p. 10. London: Kimpton.
Yates, P O (1959) Arch. Dis. Childh. 34, 436.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Wolman, L. The disturbance of circulation in traumatic paraplegia in acute and late stages: A pathological study. Spinal Cord 2, 213–226 (1965). https://doi.org/10.1038/sc.1964.39
Issue Date:
DOI: https://doi.org/10.1038/sc.1964.39
This article is cited by
-
Molecular and cellular mechanisms underlying the role of blood vessels in spinal cord injury and repair
Cell and Tissue Research (2012)