Tubbs, R.S., Demerdash, A., Oskouian, R.J., Chern, J.J., Oakes, W.J. Evolution of cerebellar tonsillar ischemia to cerebellar tonsillar cysts in the Chiari I malformation: radiological, surgical, and histological evidence. Childs Nerv Syst. doi:10.1007/s00381-015-2960-7.
Scant data are available regarding ischemic insult to the spinal cord and the responsible blood supply. Therefore, we aimed to investigate a correlation between atherosclerosis of adjacent vessels and spinal cord ischemia.
MATERIALS AND METHODS:
In 20 unembalmed adult cadavers, samples of the vertebral arteries and aorta were removed and the degree of atherosclerosis with subsequent luminal occlusion was histologically analyzed. Next, adjacent segments of the spinal cord were harvested and submitted for immunohistological analysis of both neural and glial elements and blood supply.
We identified proximal atherosclerosis in the majority of cadavers but with varying degrees of luminal occlusion. The greatest degree of luminal occlusion was found in the descending abdominal aorta. No specimen was found to have atherosclerosis of the anterior or posterior spinal or radicular arteries. No spinal cord histology showed signs of ischemia, even in specimens with a significant large parent vessel (vertebral artery and aorta) occlusion due to atherosclerosis. Neuropathology of these adjacent cord segments revealed no signs of ischemia or demyelination.
Spinal cord ischemia is often misdiagnosed and can cause significant neurological compromise. However, based on our study, the degree of atherosclerosis of the adjacent parent vessel supply does not appear to be a predictor of neuronal and glial tissue damage of the adjacent spinal cord.