Thread by @EricLawson90

‼️#Tweetorial Time‼️

“Spinal Cord Vascular Supply”

For my pub in @NeurologyCP I reviewed the vasc supply of this small space in the CNS!

cp.neurology.org/content/early/…

@MedTweetorials @RealDrHu @RyanBPetersonMD @Gradydoctor @EmmGeezee @Tracey1milligan @AaronLBerkowitz #MedEd
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I relied heavily on @neuroangio1 which has a great in depth break down.

Don’t worry, as their figure shows, this is SUPER easy stuff 🤯.

(This is the experts course)

neuroangio.org/spinal-vascula…
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I promised basics though… So lets focus on some vascular spinal cord syndromes. High yield for #MedStudentTwitter and #NeurologyResidents.
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This figure in Weidauer et al.’s paper link.springer.com/article/10.100… provides a nice overview of the different vascular syndromes.

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Let’s start with an overall review of anatomy. This figure is from the @ContinuumAAN April 2018 “Spinal Cord Disorders” Vascular Disorders of Spinal Cord.

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Main arteries to recognize are:

1. Segmental artery
2. Radiculomedulary arteries
3. Anterior spinal artery
4. Posterior spinal artery
5. Sulcal (or sulcocommissural) artery.

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Anterior Cord Syndrome:

Artery: Anterior Spinal

Tracts involved: Corticospinal, spinothalamic, and sympathetic

Symptoms: Quadriparesis, b/l loss of pain/temp, autonomic features

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Sulcal Artery Syndrome:

Artery: Sulcal (Sulcocommissural)

Tracts Involved: Corticospinal, spinothalamic

Symptoms: Incomplete Brown-Sequard: Ipsilateral weakness, Contralateral loss to pain/temp. Sparing of vibratory/proprioception.

This is the one I learned in my case!

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Posterior Cord Syndrome:

Artery: Posterior Spinal

Tracts Involved: Dorsal Columns

Symptoms: Bilateral loss of vibration, light touch, and proprioception

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Complete Cord:

Artery: Segmental (artery of Adamkiewicz most common)

Tracts Involved: Corticospinal, spinothalamic, sympathetic, dorsal columns

Symptoms: Quadriparesis, bilateral loss to pain/temp, autonomic features, bilateral loss to LT, proprioception, and vibration

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Central Cord Infarction:

Artery: Watershed between anterior/posterior spinal arteries

Tracts Involved: Corticospinal, spinothalamic

Symptoms: Man-in-the-barrel (UE>>LE weakness), bilateral oss to pain temp at level of lesion.

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And that’s it for the basics! #MedstudentTwitter I encourage you to use the patients you see to help guide your reading and learning. A patient will stick with you much longer than a page out of a book! @NMatch2021

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I used my case and publication as an excuse to learn the more in depth spinal vascular anatomy, but I hope you find this brief overview of the high yield syndromes useful!

Please join in on some teaching @Tracey1milligan @AaronLBerkowitz @Nirav_r_bhatt @DineshJillella
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