What is a Spinal Cord Stroke?
What Is a Spinal Cord Stroke?
A spinal cord stroke—also referred to as a spinal cord infarction—is a sudden disruption of blood flow to the spinal cord, leading to tissue damage and potentially permanent loss of function. Though it’s often less familiar than strokes affecting the brain, it is no less serious and requires urgent medical attention.
What Causes Spinal Cord Strokes?
Spinal cord strokes can be categorized as:
Ischemic (Blockage)
Caused by a blood clot or vessel blockage, most commonly due to conditions like atherosclerosis, clotting disorders, or heart issues such as atrial fibrillation.
Hemorrhagic (Bleed)
Caused by a rupture or leak in spinal blood vessels. This may result from high blood pressure, aneurysms, or other vascular anomalies.
Beyond these primary causes, spinal cord strokes may occasionally arise from:
Spinal surgery or trauma
Infections like meningitis
Spinal cord compression or tumors
Unknown (idiopathic) causes, where no clear source is identified
Olivia’s Experience
After extensive and repeated tests and scans, it was determined that Olivia experienced an Ischemic Spinal Cord Stoke of unknown etiology. This means that there was a blood clot in Olivia’s spine that blocked flow to her spinal cord and there was no known reason for it to have happened. It was not foreseen, nor could it have been prevented.
What Are the Symptoms?
Symptoms typically begin suddenly, often within minutes or hours, and vary according to the level of spinal cord damage:
Intense, localized back or neck pain (depending on clot/blood loss), often radiating to arms or legs.
Rapid onset of weakness or paralysis—usually in the legs but sometimes more extensive.
Loss of sensation, including numbness, tingling, or inability to feel changes in temperature or touch.
Difficulty controlling bladder and bowel function—urinary or fecal incontinence or retention.
In many cases, sensory loss is more pronounced for pain and temperature; fine touch or vibration may be preserved depending on which spinal tracts are affected.
Olivia’s Experience
On the morning of December 9, 2024, Olivia had been awake and moving around as usual. She suddenly felt severe pain and weakness in her thighs that quickly (within seconds) descended to her lower legs. The pain and weakness in her legs continued to get worse and within hours she was paralyzed. She had no reflexes and little to no sensation from her waist down, with minimal movement. She never experienced intense back or neck pain. Her bladder and bowel dysfunction would not be realized until hours later in the hospital after she was finally admitted to the Pediatric Unit from the Emergency Department.
How Rare Are They — Especially in the U.S.?
Spinal cord strokes are extremely rare, comprising a very small fraction of all strokes or neurological emergencies:
They account for approximately 0.3% to 1% of all strokes and just 1–2% of all neurological vascular emergencies.
A large autopsy study found spinal cord infarction in just 0.23% of cases.
A population-based study estimated an incidence in the U.S. of about 3.1 per 100,000 adults annually, translating to around 7,600 new hospitalizations each year for first-time spinal cord infarction . This is minuscule compared to the roughly 795,000 strokes per year in the U.S.
Our Experience
We had never heard of a Spinal Cord Stroke until 3+ weeks after the onset of Olivia’s injury when she was transferred to the third hospital—Boston Children’s Hospital—for proper diagnosis. Olivia now lives with a Spinal Cord Injury.
Why You Don’t Hear Much About Spinal Cord Strokes
Because spinal cord strokes are so rare, finding clear and consistent information about them can be difficult. Many people—including patients, families, and even some healthcare providers—have never heard of them until they happen. Research is limited compared to brain strokes, but awareness is slowly growing.