Thrombolysis in Ischemic Spinal Cord Stroke
Thrombolysis in Ischemic Spinal Cord Stroke
Ischemic stroke of the spinal cord is a rare disease accounting for about 1% of all ischemic
 events in the central nervous system (CNS). In most cases the consequences are catastrophic,
 with a high rate of severe functional disability and mortality rate up to 30%.

 Ischemic stroke of the spinal cord can arise from:

 1. Dissection of the aorta.

 2. Aneurism in the aorta.

 3. Atherosclerotic disease of the aorta or vertebral arteries.

 4. Spinal surgeries.

 5. Spinal AVM.

 6. Embolism from cardiac origin.

 7. Occlusion of radicular artery. Onset is usually sudden, reaching maximal intensity in
 hours until the patient becomes paralyzed in two or in all four limbs. In most cases the
 damage is in the Anterior Spinal Artery (ASA). The disease is expressed with motor
 weakness accompanied by disturbance of temperature and superficial sensation, urinary
 retention or bowel disorder, with preserved position and vibration sense.

 The differential diagnosis of ischemic spinal cord includes diseases such as acute myelitis
 of the spinal cord or acute demyelinating polyneuropathy like Guillan Barree Syndrome (GBS).
 Therefore in order to reach the appropriate diagnosis in most cases an urgent MRI of the
 spinal cord is necessary upon arrival in the emergency department.

 One of the treatments to acute ischemic stroke is providing thrombolysis. As tested and
 validated in numerous studies for ischemic events in the brain, until today no validated
 study in ischemic spinal stroke using thrombolysis has been completed.
Inclusion Criteria:

 1. Patients with vascular risk factors

 2. Patients with sudden weakness of the lower or upper limbs together with bowel
 disorder.

 3. Window treatment - not over 6 hours since the start of the event till the start of the
 treatment.

 4. Patient without dissection of the aorta in the abdomen.

 5. Patient without contraindication to IVtPA.

 6. Patient with no etiology found after clarification.

 Exclusion Criteria:

 1. Refusal to sign an ICF. 2. Reason for weakness is known. 3. Patient with
 contraindication IVtPA.

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