Spinal Cord Stroke

Getty Images/ Compassionate Eye Foundation/Dan Kenyon

If you or a loved one has been told that you have had a spinal cord infarct, you most likely do not know what to expect. Most people have never heard of a spinal cord infarct before. While the majority of strokes affect the brain, there are strokes that affect the spinal cord, and they are called spinal cord infarcts or spine infarcts. Spinal infarcts account for only about 1% of all strokes. The triggers and effects of spinal infarcts vary.

What they all have in common is spinal cord damage caused by lack of blood flow to the spinal cord or to a region of the spinal cord. The effects of a spinal cord infarct depend on the location of the infarct within the spinal cord, how severe the injury is, and also on whether the spinal infarct is medically treated quickly. 

What Is a Spinal Cord Stroke?

The spinal cord, like every part of the body, needs to receive blood in order to get oxygen and nutrients. The oxygen and nutrients allow the spine to function and survive. There are blood vessels, called spinal arteries, which deliver oxygen-rich, nutrient-rich blood to the spinal cord. If blood flow through one or more of the spinal arteries is interrupted, then the region of the spinal cord that normally receives blood through that blood vessel suffers. That is a spinal cord stroke, normally called a spinal infarct. 

What Is the Spinal Cord?

Your spinal cord is enclosed within your spine (backbone.) Your spinal cord is a relay station that connects the messages between the different parts of your body and your brain.

When you want to move one of your muscles, your brain sends messages through your spinal cord and then through the nerves that control that particular muscle, and finally out to your muscle, so that your muscle can move. Similarly, when you feel a sensation in a part of your body, the nerves on your skin send messages through your spinal cord to your brain so that you can become aware of your body's sensations.


Any damage from a spinal infarct can affect the spinal cord’s ability to function as an effective relay station, interfering with your sensation or your muscle movements, or both. 

What Are the Consequences of a Spinal Cord Infarct?

If you have had a spinal cord infarct, you may experience permanent neurological effects as a result. The particular effects depend on the location of the spinal infarct and how severe it is. 

The location of a spinal infarct is described according to the height and depth of the spinal cord. One component of spinal cord location is based on the ‘up and down’ level within the spinal cord, defined as the spinal cord level. The other component of spinal cord location depends on how far ‘in or out’ of the spinal cord the injury is, described as the spinal tract. 

Spinal Cord Level

The spinal cord level describes how high or low the spinal infarct is, and the higher a spinal infarct is, the worse the damage. This means that when a spinal infarct occurs near the neck, at the level of the cervical spinal cord, the resulting problem will affect bodily functions at and below the neck.

When a spinal infarct occurs in the middle and lower portions of the back, at the regions of the thoracic and lumbar spinal cord, then bodily functions in the legs and lower parts of the body will be affected, not bodily functions in the arms and upper parts of the body.

Spinal Tract

The spinal cord is shaped somewhat like a solid circular tube, although it is not a perfect circle, and it is not perfectly solid. The parts of the spinal cord nearer to the back of the body control functions such as sensation, and the parts of the spinal cord nearer the interior of the body control functions such as movement. Also, the left side of the spinal cord controls only half of the body’s sensation and movement, while the right side of the spinal cord controls half of the body’s sensation and movement.

The particular ‘job’ of a section within the spinal cord is often referred to as a tract. A spinal infarct has different effects depending on which tract was injured and on whether the infarct affected the right side of the spinal cord or the left side of the spinal cord, or both. Some spinal infarcts cause a problem with sensation, some cause a problem with muscle strength, some affect the right side and some affect the left side. Most spinal infarcts cause a combination of these problems because a spinal infarct normally damages more than one spinal tract at a time.

What Is the Treatment of Spinal Cord Infarct?

The treatment of spinal cord infarct may include blood thinners if a blood clot is the cause of the spinal infarct. Some new treatment options for spinal cord infarct include powerful blood thinners, such as tissue plasminogen activator (TPA), but there are only a  few scientific studies describing the effectiveness of TPA in the setting of a spinal infarct. If your doctors decide to treat you with emergency TPA for a spinal infarct, this is a decision that must be made very quickly to maximize effectiveness and to minimize dangerous complications, such as bleeding.

Sometimes, bleeding is the cause of a spinal infarct. In such situations, it is usually the result of a bleeding abdominal artery, and surgery may be indicated, sometimes urgently. 

Prognosis of Spinal Cord Infarct

The bad news is that a spinal cord infarct often results in very bad outcomes. There are a few reasons for this:

One of the more serious causes of emergency spinal cord infarct, abdominal aneurysm rupture, is a dangerous and life threatening condition that causes rapid and severe bleeding and blood loss. Several of the causes of spinal cord infarct are related to severe trauma and other major illness, which makes battling spinal cord infarct along with the other disease that caused the spinal cord infarct a huge uphill challenge.

The other reason that spinal cord infarcts often result in bad outcomes is that the spinal cord damage is particularly hard to recover from. It is rare for medical intervention to ‘bring back’ any function lost from a spinal infarct. Most of the time, medical intervention for spinal cord damage is a way to prevent further damage, not to restore or repair spinal cord damage.

New research to discover treatments for incurable diseases like spinal cord damage include research on neuroplasticity, which is repairing damaged nerves, and research on stem cell therapy, which replaces damaged nerves.

What Is the Cause of Spinal Cord Infarct?

There are a number of causes of spinal cord infarct. This problem is not typically caused by heart disease and atherosclerosis, which are the usual causes of an infarct in the brain. Spinal cord infarct may result from bleeding or blood clots in one of the blood vessels of the abdomen, particularly the abdominal aorta. Severe trauma to the body can compromise the blood flow to the spinal cord, causing spinal cord infarct. Other causes of spinal cord infarct include infections, cancer, blood diseases and autoimmune or inflammatory disease. If you or a loved one has had a spinal infarct, then your doctors will work quickly to find out the cause and to treat the cause as soon as possible.

Living With Spinal Cord Infarct

Life after spinal cord infarct may require serious lifestyle adjustments. If you or your loved one do not have a major disability as a result of the spinal cord infarct, then the key component of recovery involves medical management of the cause of spinal infarct. If you have a major disability, then dedicated physical therapy and occupational therapy can help you maximize your abilities and learn how to keep your body as healthy and safe as possible. The United Spinal Association and the Christopher and Dana Reeve Foundation are a few of the organizations dedicated to providing resources and help for people living with spinal cord injury.


Koch M, Sepp D, Prothmann S, Poppert H, Seifert CL. Systemic thrombolysis in anterior spinal artery syndrome: what has to be considered?. J Thromb Thrombolysis. 2016;41(3):511-3.

Lee J, Lim YM, Kim KK. A case of spinal cord infarction caused by polycythemia vera. Spinal Cord. 2015;53 Suppl 1:S19-21.

Munyon CN, Hart DJ. Vascular disease of the spine. Neurologist. 2015;19(5):121-7.

Rabinstein AA. Vascular myelopathies. Continuum (Minneap Minn). 2015;21(1 Spinal Cord Disorders):67-83.

Rigney L, Cappelen-smith C, Sebire D, Beran RG, Cordato D. Nontraumatic spinal cord ischaemic syndrome. J Clin Neurosci. 2015;22(10):1544-9.

Continue Reading