Can a stroke affect the spine? (Spinal Stroke) Let's talk about this!

When we hear the word "stroke," we usually think of something that happens to the brain. But did you know that, although very rarely, our spine, or spinal cord, can also experience a similar condition? This is what we call a "spinal stroke." Although this is a bit unexpected, it is very important to be aware of this.

So what is this spinal stroke?

Simply put, a spinal stroke is a sudden interruption of blood flow to your spinal cord, the vital nerve system located inside your spine. It's similar to a brain stroke, but it happens in your spine. Doctors also call it a "spinal cord stroke" or "spinal infarction."

Like a stroke, a blood vessel in the spinal cord can be blocked by a blood clot (called an ischemic stroke) or a blood vessel bursts and bleeds (called a hemorrhagic stroke). This is very rare – less than 1% of all strokes in the world affect the spinal cord in this way. But just because it’s rare doesn’t mean it’s not rare. It can be life-threatening or even permanently disabling.

Therefore, if you or someone you know is experiencing symptoms of a spinal cord stroke, you should call 1990 (Sri Lankan Ambulance Service) immediately. The sooner you get diagnosed and treated, the greater the chance of saving a life. Every second counts here.

What are the symptoms of a spinal stroke?

The symptoms of a spinal cord stroke can vary from person to person. They also vary depending on which part of the spinal cord is affected. However, there are some common symptoms that can be seen:

• A sudden, severe pain in the neck or back. This is not just a normal backache, but a pain that is a little more intense and unexpected.
• It feels like the pain is spreading from the back to the arms or legs. Some people even say that the pain feels like electricity.
• Numbness or tingling in the hands or feet.
• Muscle weakness (especially in the legs). Difficulty standing or walking, and a feeling of weakness in the legs.
• Loss of sensations such as touch, heat/cold.
• It is either urinary incontinence or bowel incontinence.
• Paralysis or loss of body function. This is a somewhat severe symptom.

If you experience one or more of these symptoms at once, don't take it lightly. The best thing to do is to seek medical advice immediately.

Why does this spinal stroke occur?

There are two main ways, or causes, that a spinal stroke can occur.

1. Ischemic Spinal Stroke

This is the most common type. "Ischemic" means a lack of blood supply. This is when a blood clot blocks a blood vessel in the spine. It's like a piece of dirt getting stuck in a water pipe. There are some health conditions that increase your risk of developing blood clots like this:

• Increased blood cholesterol levels (Hyperlipidemia).
• Atherosclerosis: This is when substances like cholesterol build up inside the blood vessels, clogging them.
• Clotting disorders.
• Atrial Fibrillation. This is a condition in which the heart beats irregularly. The risk is especially high when this condition is accompanied by sleep apnea.
• Heart defects. Examples include "Atrial Septal Defect" and "Ventricular Septal Defect".

2. Hemorrhagic Spinal Stroke

"Hemorrhagic" means bleeding. This is when a blood vessel in the spinal cord bursts or tears and starts bleeding. This can be caused by:

• High Blood Pressure. This risk is higher if you have high blood pressure for a long time, especially if it is uncontrolled.
• Spinal tumors.
• Aneurysms. This is when the wall of a blood vessel weakens and bulges like a balloon. If this happens in an artery in the spine, it can burst.

Other rare causes

In addition to these two main causes, spinal cord strokes can also occur for other reasons, very rarely:

• Spinal cord injuries.
• Infections like meningitis.
• Accidental injuries during surgery.
• Spine fractures.

Who is at higher risk for developing a spinal stroke?

Anyone can have a spinal stroke, but some people are at a higher risk.

• People who smoke or use other nicotine-containing products (e.g., vaping).
• People over 65 years of age.
• Black people (Although this is a scientifically recognized fact, it can occur in people of any race.)
• People who use illegal drugs.

Also, the risk of stroke increases if you have certain health conditions:

• High blood pressure (Hypertension)
• High cholesterol in the blood (Hyperlipidemia)
• Covid-19 (COVID-19) infection
• Diabetes
• Obesity (being overweight)
• Alcohol use disorder

If you have one or more of these things, it is very important to be careful and follow medical advice.

What complications can occur from a spinal stroke?

This can be life-threatening. Also, if there is permanent damage to the spinal cord, there is a risk of more serious complications:

• Permanent paralysis
• Chronic pain
• Breathing problems
• Sexual dysfunction
• Permanent incontinence

It is because of things like this that if you experience even the slightest symptom, you should see a doctor immediately.

How do doctors determine exactly if this is a spinal stroke?

If you have symptoms of a spinal stroke, a doctor will do several tests to confirm this. First, they will do a physical exam and a neurological exam .

Next, you will be asked to have an MRI (Magnetic Resonance Imaging) test . This takes detailed pictures of the spine to check for signs of a stroke or other causes.

Sometimes, a test called a "lumbar puncture" or "spinal tap" may be done. This involves taking a sample of cerebrospinal fluid from the spine to check for infection or other inflammation.

What are the treatments for a spinal stroke?

Treatment varies depending on the type of stroke you have had. The main goal of doctors is to restore blood flow to the spinal cord as quickly as possible.

If an ischemic stroke...

There's a blood clot stuck in there. So they're trying to either dissolve the clot and remove it, or break it up and remove it.

• Blood thinners (Anticoagulants).
• Thrombolytic medications or "clot-busting" medications.
• Sometimes surgery, such as mechanical thrombectomy, is performed to remove the blood clot.

Also, they give medication to control blood pressure.

If a hemorrhagic stroke...

The first step is to stop the bleeding. This involves giving medications to control bleeding and blood pressure. Sometimes, if the bleeding has increased pressure inside the spine, surgery may be necessary to reduce the pressure.

Doctors will explain to you what treatments are right for you and what to expect from them.

Is rehabilitation important after a stroke?

Absolutely! "Stroke Rehab" is part of the treatment itself.

Physical therapy strengthens your muscles, improves your balance, and helps you regain the use of your arms and legs.

Occupational therapy helps you perform your daily tasks and household chores safely.

Is it possible to fully recover from a spinal cord stroke?

The prognosis depends on several factors: the type of stroke, how quickly treatment is received, whether there is permanent damage to the spinal cord, your overall health, and your age.

"Complete recovery" is different for each person. It may take several months for some people to fully regain their previous abilities. Others may have to live with new disabilities. For example, they may continue to need a walker or cane to help them walk. But some people eventually recover completely. This can take years, but it is not impossible. Your doctor will help you set appropriate recovery goals.

What is the survival time after a spinal cord stroke?

This can be a life-threatening condition. However, it is difficult to say exactly how long you will live. In general, the outcomes of ischemic strokes are said to be slightly better than hemorrhagic strokes. However, everyone's body responds differently.

What can we do to prevent a spinal stroke?

The best thing to do is to maintain your overall health .

• If you smoke, stop it.
• Eat a healthy diet (e.g., the Mediterranean Diet) and maintain a healthy weight.
• Keep your blood pressure, cholesterol levels, and diabetes under control.
• Engage in regular physical exercise.
• Get a medical checkup every year. Many of the conditions that cause this don't show symptoms at first.

How do I take care of myself after a stroke?

Healing takes a lot of effort.

• Be sure to go to your rehabilitation and therapy appointments. Tell your therapists if you have any concerns.
• Think about your mental health too.Depression and anxiety are common after a stroke. Feeling sad is not a weakness. Talk to a doctor or mental health counselor if you need to.
• Take your medicine correctly and on time.

Remember, you don't have to go through this journey alone. Your family, friends, and doctors are all there to help you.

What should you do if stroke symptoms occur again or if another emergency occurs?

If you feel like you're having another stroke, call 911 immediately. The risk of another stroke is high.

People who have had a stroke can also develop other serious complications, such as:

• Heart Attack
• Pneumonia
• Deep Vein Thrombosis (DVT)
• Pulmonary Embolism (blood clot in the lungs)
• Seizures

If you experience any of these symptoms, go to a hospital immediately.

What should I ask my doctor?

• What type of stroke did I have?
• What medications do I need and how do I take them?
• What rehabilitation services do I need?
• Am I at risk of having another stroke?

Don't be afraid to ask your doctor anything you think or have any doubts about.

Finally, all I have to say to you is this...

Spinal stroke can happen suddenly. Some symptoms may be ignored at first. But don't be. No one knows your body better than you. If you feel anything strange, don't take it lightly. The sooner you get treatment, the better the outcome.

Celebrate even the smallest improvements you make during your recovery. Rehabilitation is a huge physical and mental challenge. You deserve to be recognized for every effort you make. Talk to your doctors and therapists. Never give up hope!

` Spinal Stroke, Spinal Cord, Stroke Symptoms, Stroke Treatment, Paralysis, Rehabilitation