Anterior Spinal Artery Occlusion

The anterior spinal artery (ASA) has multiple anastomoses along its path and therefore spinal stroke due to ASA occlusion is a rare event. Following an ASA occlusion, collateral blood flow, although inadequate to meet the needs of the spinal cord, may be enough to prevent a sudden stroke and instead may result in a gradual loss of cord function. The etiologies are mostly embolic, inflammatory, and traumatic. Atherosclerosis and resultant stroke is very rare in the ASA. The acute ASA syndrome is characterized by bilateral flaccid paresis or plegia below the lesion level, loss of motor reflexes, and dissociated sensory loss. Treatments are focused on the prevention of secondary ischemic events and on management of complications related to spinal cord dysfunction.