Spinal cord infarction, or spinal cord infarct, is an acute neurologic injury involving a segment of the spinal cord. It is caused by ischemia to the spinal cord due to vascular occlusion or hypoperfusion of one or more spinal arteries. The anterior spinal artery is the most frequently affected blood vessel, causing infarctions in the anterior portion of the spinal cord. Spinal cord infarctions are relatively uncommon, with an annual incidence of 3 per 100­ 000 people and representing just 1% of all strokes. Most cases occur spontaneously, particularly in patients with vascular risk factor. It can also occur because of trauma, as a complication of vascular surgery, or as a result of arterial dissections and aneurysms. Spinal cord infarctions can mimic inflammatory and infectious causes of myelopathy.

Signs and symptoms vary depending on the level of spinal cord involvement. Common symptoms include weakness and/or loss of sensation below the level of the infarction, urinary or stool incontinence, and neck or back pain. Infarctions in the cervical spinal cord can cause respiratory insufficiency, which is potentially life-threatening. Patients typically present acutely, with symptom onset over minutes to hours; however, symptoms may start gradually over several days and can be stuttering in onset.

Management includes supportive care. Cervical spinal cord infarctions can be life-threatening due to the potential for respiratory failure and autonomic instability. There is no standard therapy for spinal cord infarctions, and treatment depends on the suspected underlying cause of the infarction. Most patients will experience some neurological improvement; however, permanent leg weakness is common and up to one-third of patients need to use a wheelchair.