Spinal Stroke

What is a spinal stroke?

A spinal stroke is a type of stroke that stops blood flow in your spinal cord. Healthcare providers also call them spinal cord strokes, spinal infarctions or spinal infarcts.

Most strokes happen when a blood vessel in your brain is blocked by a blood clot or breaks (ruptures) and bleeds. The same issues cause spinal strokes, but the blockage or bleeding (hemorrhage) happens in your spinal cord.

Spinal strokes are very rare (less than 1% of all strokes). But they can still be fatal or cause permanent disabilities.

If you think you or someone you’re with is having a spinal stroke, immediately call 911 (or your local emergency services number). The sooner someone is diagnosed and treated, the more likely it is they’ll survive a stroke. Every second counts.

What are spinal stroke symptoms?

A spinal stroke can cause lots of different symptoms depending on which part of your spinal cord it affects. Some of the most common symptoms include:

• Sudden, intense neck pain or back pain
• Pain that spreads (radiates) from your back into your arms or legs
• Numbness or tingling in your arms or legs
• Muscle weakness (especially in your legs)
• Losing sensations like touch or noticing temperature changes
• Losing control of your pee (urinary incontinence) or poop (bowel incontinence)
• Paralysis

What causes a spinal stroke?

There are two types of spinal strokes that have different causes.

Ischemic spinal strokes happen when a blood clot blocks a blood vessel in your spinal cord. Most spinal cord strokes are ischemic. Health conditions that increase your risk of blood clots can include:

• High cholesterol (hyperlipidemia)
• Atherosclerosis (hardened arteries)
• Clotting disorders
• Atrial fibrillation (especially when sleep apnea causes it)
• Heart defects (including atrial septal defect and ventricular septal defect)

Hemorrhagic spinal strokes happen when a vessel in your spinal cord breaks or tears. Causes can include:

• High blood pressure (especially if it’s very high or you have it for a long time)
• Spinal tumors
• Aneurysms

It’s rare, but other causes can include:

• Spinal cord injuries
• Infections like meningitis
• Accidental damage during surgery
• Spine fractures (broken back)

Risk factors

Anybody can experience a spinal stroke, but you may have higher risk if you:

• Smoke or use other forms of tobacco or nicotine (like vaping)
• Are older than 65
• Are Black
• Use recreational or nonprescription drugs

Having certain health conditions can increase your stroke risk, including:

• High blood pressure (hypertension)
• High cholesterol (hyperlipidemia)
• COVID-19
• Diabetes
• Obesity
• Alcohol use disorder

What are the complications of a spinal stroke?

A spinal stroke can be fatal. It can also permanently damage your spinal cord, which can cause:

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

How do healthcare providers diagnose a spinal stroke?

A healthcare provider will diagnose a spinal stroke with a physical exam, a neurological exam and tests. Providers in the emergency room may diagnose it if emergency services transport you to the ER.

Your provider will use an MRI to take pictures of your spinal cord. This will let them check for signs of a stroke or other issues that could cause the symptoms you’re experiencing. They might use a lumbar puncture (spinal tap) to check for infections or signs of inflammation in your cerebrospinal fluid. These issues can share symptoms with spinal strokes.

What are spinal cord stroke treatments?

Spinal cord stroke treatments vary depending on which type you experience. Your healthcare providers will try to restore normal blood flow to your spinal cord as fast as possible to reduce your risk of death and permanent complications.

If the stroke is ischemic, your providers will try to break up or remove the blood clot. You might need:

• Blood thinners (anticoagulants)
• Thrombolytic medications (clot-busting medications)
• Surgery (usually a mechanical thrombectomy) to break up and remove the clot

Your providers may also give you medications to manage your blood pressure.

If you had a hemorrhagic stroke, your providers will stop the bleeding in your spinal cord. You’ll need medications to control the bleeding and manage your blood pressure. You might need surgery to reduce increased pressure on your spinal cord from the bleeding in or around it.

Your providers will tell you exactly which treatments are best for you and what to expect.

Spinal cord stroke rehabilitation

Stroke rehab is an important part of stroke treatment. Physical therapy will strengthen your muscles, improve your balance and help you regain full or partial use of your arms and legs. You might also need occupational therapy to help you safely complete your daily tasks, especially chores or activities that need precise body movements.

Can you prevent a spinal cord stroke?

Maintaining your overall health is the best way to reduce your risk of a spinal cord stroke. In general, try to:

• Quit smoking.
• Eat plenty of healthy foods (like the Mediterranean diet) and maintain a weight that’s healthy for you.
• Manage your blood pressure, cholesterol and any health conditions you have.
• Get regular physical activity.

Visit a healthcare provider every year (or as often as they suggest). Many of the conditions that can cause spinal cord strokes develop or build up over time. Some don’t cause symptoms you can feel or notice. For example, many people with high cholesterol or high blood pressure never sense anything wrong before they’re diagnosed. Your provider will help you catch and manage any warning signs before they increase your stroke risk.

Can you fully recover from a spinal stroke?

What you can expect (the prognosis) after a spinal stroke depends on a few factors, including:

• Which type of stroke you had
• How quickly it was treated
• If the stroke permanently damaged your spinal cord
• Your overall health
• Your age

A full recovery looks different for each person. You might regain all of your original body functions and abilities to move. This usually takes at least a few months. But you might have long-term effects like new or different disabilities.

For example, you’ll probably need a walker or a cane while you recover. You might need one for the rest of your life. But some people eventually regain their full original mobility. It can take years, but it’s possible.

Your provider will tell you what to expect. They’ll help you set recovery goals and expectations that fit your unique health and situation.

Life expectancy after a spinal stroke

Spinal strokes can be fatal. But it’s hard for experts to estimate an accurate survival rate. There’s no standard recovery timeline or outlook that’s accurate for everyone.

Ischemic strokes usually have better outcomes than hemorrhagic strokes, but that doesn’t mean your recovery will be easier, faster or better if you have one type or the other. Everyone’s body responds differently to a stroke.

How do I take care of myself after a spinal stroke?

Rehabbing and recovering after a stroke is hard work. Once you and your provider finalize your treatment plan, follow it as closely as possible. In general, you should:

• Go to your rehab and other therapy appointments. Tell your therapists if anything makes you feel unsafe or uncomfortable. Rehab can be tough, but you shouldn’t be in constant pain or discomfort.
• Remember your mental health. Depression and anxiety are extremely common after a stroke. You’re not weak or a quitter for feeling sad or upset. Your emotional health can be just as important as how your physical body is doing. Talk to your provider or a mental health professional if you feel like you need help processing anything during your recovery.
• Take your medications. Taking your medicine as often as your provider instructs will help your body heal.

When should I go to the ER?

Call 911 (or your local emergency services number) if you think you’re experiencing stroke symptoms again. Another stroke has an even higher risk of being fatal or causing severe complications. Don’t wait to call for help.

People who’ve had a stroke have an increased risk of other potentially serious complications, including:

• Heart attack
• Pneumonia
• Deep vein thrombosis (DVT)
• Pulmonary embolism
• Seizures

Call emergency services or go to the ER if you think you’re experiencing any symptoms of these issues.

Which questions should I ask my healthcare provider?

• Which type of stroke did I have?
• Which medications will I need and how do I take them?
• Which kinds of rehab will I need?
• What is my risk of another stroke in the future?