Subacute Post-Traumatic Ascending Myelopathy (SPAM) in a Spinal Cord Injured Patient - a Rare Presentation: A Case Report

The case report describes a patient who experienced neurological deterioration after an initial spinal cord injury due to multiple episodes of hypotension. This condition, known as Subacute Post-traumatic Ascending Myelopathy (SPAM), is rare but preventable. The patient's blood pressure instability, attributed to autonomic dysfunction, led to ischemia of the spinal arteries, causing an ascending pattern of neurological deterioration. Proper management of blood pressure is crucial in preventing this complication. The diagnosis of SPAM was made after ruling out other causes of worsening neurological function. The patient's condition improved with blood pressure management and rehabilitation therapy, highlighting the importance of early recognition and intervention.

• 1
  Hypotension can lead to neurological deterioration in spinal cord injury patients, resulting in Subacute Post-traumatic Ascending Myelopathy (SPAM).
• 2
  Blood pressure lability due to autonomic dysregulation can cause ischemia of the spinal arteries, leading to an ascending pattern of neurological deficits.
• 3
  Proper blood pressure management and rehabilitation therapy can improve the patient's condition and prevent further neurological deterioration.