Surgical Neurology International, 2018 · DOI: 10.4103/sni.sni_405_17 · Published: January 16, 2018
A 14-year-old male became acutely tetraplegic with a C4 sensory level and sphincteric dysfunction 12 h following surgery for tracheal stenosis due to prior intubation. The cervical magnetic resonance imaging revealed diffuse intramedullary cord swelling between C2‑C7 and hyperintense signal changes in the anterior and posterior columns of the cord on T2‑weighted images. Various etiologies for this finding included a cervical hyperextension or hyperflexion injury vs. anterior spinal artery syndrome.
Emphasis on preventing spinal cord ischemia during cervical and thoracoabdominal surgeries through careful monitoring and management of blood pressure, anemia, and surgical positioning.
Increased awareness of ASAS as a potential complication following not only spinal but also head and neck surgeries, leading to prompt diagnosis and intervention.
Recognition of the limited effectiveness of current postoperative treatments for spinal cord ischemia, prompting further research into more effective neuroprotective strategies.