The anterior spinal artery syndrome in three patients is described and from the literature 6o additional patients were collected. Motor recovery in the following groups of patients was noted: (1) Partial loss of motor function and pain sensation—70.4 per cent (19/27); (2) Complete motor loss but partial loss of pain—83.3 per cent (5/6); (3) Paresis but pain sensation absent—66.7 per cent (6/9); and (4) Absent motor function and pain—38.9 per cent (7/18). Motor recovery was also found to vary according to aetiology: (A) Unknown cause— 92.9 per cent (13/14); (B) Post-infection or vaccination—88.9 per cent (8/9); (C) Anterior spinal artery occlusion—33.3 per cent (3/9); (D) Spinal cord angioma—20 per cent (2/10); and (E) Aortic lesion—2o per cent (1/5).
Patients with sparing of motor function or pain sensation below the lesion do better than those without both functions. Neurological return also varies with the aetiology of the syndrome.
Albert, M L, Greer, W E R, Kantrowitz, W (1969). Paraplegia secondary to hypotension and cardiac arrest in a patient who has had previous thoracic surgery. Neurology (Ny), 19, 915–918.
Blankenhorn, D, Wolff, H G (1948). Myelitis following the administration of neoarsphenamine. J. Lab. Clin. Med., 33, 1165–1168.
Case Records (Case 38012) of the Massachusetts General Hospital (1952). Anterior spinal artery thrombosis. New Engl. J. Med., 246, 30–34.
Clinicopathologic Conference (1968). A sixty-six year old man with the sudden onset of left-sided chest and arm pain, weakness of the extremities and urinary retention. Am. J. Med., 44, 430–440.
Coupland, G A E, Reeve, T S (1968). Paraplegia: a complication of excision of abdominal aortic aneurysm. Surgery, 64, 878–881.
Deller, J J Jr, Scalettar, R, Levens, A J (1960). Pain as a manifestation of acute anterior-spinal-artery thrombosis. New Engl. J. Med., 262, 1078–1079.
Fiebrand, H (1966). Zur Pathogenese des Spinalis-anterior-Syndroms. Schweiz. Arch. Neurol. Neurochir. und Psychiat., 97, 227–233.
Foo, D, Subrahmanyan, T S, Rossier, A B (1981). Post-traumatic acute anterior spinal cord syndrome. Paraplegia, 19, 201–205.
Foo, D, Bignami, A, Rossier, A B (1982). Post-traumatic anterior spinal cord syndrome: pathological studies of two patients. Surg. Neurol., 17, 370–375.
Garland, H, Greenberg, J, Harriman, D G F (1966). Infarction of the spinal cord. Brain, 89, 645–662.
Grinker, R R, Guy, C C (1927). Sprain of cervical spine causing thrombosis of anterior spinal artery. J. A. M. A., 88, 1140–1142.
Henneaux, J (1960). Étude clinique et anatomo-pathologique de deux cas de thrombose de l’artère spinale antérieure. Rev. Neurol., 102, 44–60.
Hogan, B W (1942). Acute myelitis: syndrome of occlusion of the anterior spinal artery at the first thoracic cord segment with softening of the cord. U. S. Navy Med. Bull., 40, 175–178.
Hogan, E L, Romanul, F C A (1996.). Spinal cord infarction occurring during insertion of aortic graft. Neurology (Ny), 16, 67–74.
Hughes, J T (1978). Pathology of the Spinal Cord, 2nd ed. Lloyd-Luke, London.
Hughes, J T, Brownell, B (1964). Cervical spondylosis complicated by anterior spinal artery thrombosis. Neurology (Ny), 14, 1073–1077.
Killen, D A, Foster, J H (1966). Spinal cord injury as a complication of contrast angiography. Surgery, 59, 969–981.
Lyon, L W (1971). Transfemoral vertebral angiography as a cause of anterior spinal artery syndrome: case report. J. Neurosurg., 35, 328–330.
Mosberg, W H JR, Voris, H C, Duffy, J (1954). Paraplegia as a complication of sympathectomy for hypertension. Ann. Surg., 139, 330–334.
Mulder, D G, Grollman, J H (1969). Traumatic disruption of the thoracic aorta: diagnostic and surgical considerations. Am. J. Surg., 118, 311–316.
Paine, R S, Byers, R K (1953). Transverse myelopathy in childhood. Am. J. Dis. Child., 85, 151–163.
Parman, S C (1980). Spontaneous spinal epidural hematoma: case report. Ann. Emerg. Med., 9, 368–370.
Parmley, L F, Mattingly, T W, Manion, W C, Jahnke, E J JR (1958). Non-penetrating traumatic injury of the aorta. Circulation, 17, 1086–1101.
Peterman, A F, Yoss, R E, Corbin, K B (1958). The syndrome of occlusion of the anterior spinal artery. Proc. Mayo Clinic, 33, 31–37.
Schaller, W F, Roberts, A M, Stadtherr, E F (1932). Acute myelitis (myelomalacia): syndrome of occlusion of the anterior spinal artery at the fifth cervical cord segment. J. A. M. A., 99, 1572–1575.
Slavin, R E, Gonzalez-Vitale, J C, Marin, O S M (1975). Atheromatous emboli to the lumbosacral spinal cord. Stroke, 6, 411–416.
Spiller, W G (1909). Thrombosis of the cervical anterior median spinal artery; syphilitic acute anterior poliomyelitis. J. Nerv. & Ment. Dis., 36, 601–613.
Steegmann, A T (1952). Syndrome of the anterior spinal artery. Neurology (Ny), 2, 15–35.
Strassman, G (1947). Traumatic rupture of the aorta. Am. Heart J., 33, 508–515.
Watson, A B (1967). Spinal subarachnoid haemorrhage in patient with coarctation of aorta. Br. Med. J., 4, 278–279.
Weisman, A D, Adams, R D (1944). The neurological complications of dissecting aortic aneurysm. Brain, 67, 69–92.
Wieringen, A V (1968). An unusual cause of occlusion of the anterior spinal artery. Europ. Neurol., 1, 363–374.
Wyburn-Mason, R (1943). Vascular Abnormalities and Tumours of Spinal Cord and Its Membranes. Henry Kimpton, London.
Zeitlin, H, Lichtenstein, B W (1936). Occlusion of the anterior spinal artery: clinicopathologic report of a case and a review of the literature. Arch. Neurol. Psychiat., 36, 96–111.
Rights and permissions
About this article
Cite this article
Foo, D., Rossier, A. Anterior spinal artery syndrome and its natural history. Spinal Cord 21, 1–10 (1983). https://doi.org/10.1038/sc.1983.1
- Anterior spinal artery (ASA)
- Motor function
- Pain sensation
This article is cited by
Young Woman with Sudden-Onset Neck Pain and Quadriplegia: a Case Report
SN Comprehensive Clinical Medicine (2021)
Neurological symptoms in acute Leriche’s syndrome
Clinical Research in Cardiology (2010)
Anterior spinal artery syndrome complicating massive paravertebral abscess
Journal of Orthopaedic Science (2008)
Spinal Cord Ischemia following Endovascular Repair of an Infrarenal Aortic Aneurysm
Annals of Vascular Surgery (2002)
Anterior spinal artery syndrome of the cervical hemicord
European Archives of Psychiatry and Clinical Neuroscience (1992)