Clinical features

The clinical features of spinal artery infarction depend upon the segmental level of damage. Typical features include:

• sudden radicular pain and para- or quadra-paresis
• 'spinal shock'-like phenomena:
  • limbs initially flaccid but within days, become spastic
  • reflexes initially absent but within days, become hyper-reflexic with extensor plantars
• loss of pain and temperature sensation up to the level of cord damage - due to involvement of anterolateral spinothalamic tracts
• urinary and faecal incompetence from lesions in the lower lumbar / sacral areas

N.B.: fine touch and joint position sense are usually unaffected since the dorsal columns are supplied by the posterior spinal artery.