A spinal stroke, also called a spinal cord stroke, occurs when the blood supply to a section of the spinal cord is cut off. The spinal cord is part of the central nervous system (CNS), which also includes the brain.

A spinal stroke occurs when blood cannot reach part of the spine. While the blood supply is cut off during a spinal stroke, the affected part of the spinal cord can’t get oxygen and nutrients.

The tissues may be damaged and not be able to send nerve impulses (messages) to the rest of your body. These nerve impulses are vital for controlling activities of the body, such as moving the arms and legs and allowing your organs to work properly.

The majority of spinal strokes are caused by a blockage in the blood vessels that supply blood to the spinal cord, such as a blood clot. These are called ischemic spinal strokes. A small number of spinal strokes are caused by bleeds. These are called hemorrhagic spinal strokes.

A spinal stroke is different than a stroke that affects the brain. In a brain stroke, the blood supply to a part of the brain decreases. Spinal strokes are much less common than strokes that affect the brain, accounting for no more than 1 percent of all strokes.

The symptoms of a spinal stroke depend on what part of the spinal cord is affected and how much damage is done to the spinal cord.

In most cases, symptoms will appear suddenly, but they may come on hours after the stroke occurs. Symptoms include:

  • sudden and severe neck or back pain
  • muscle weakness in the legs
  • problems controlling the bowel and bladder (incontinence)
  • numbness
  • tingling sensations
  • paralysis
  • inability to feel heat or cold

This is different from a brain stroke, which also results in:

  • difficulty speaking
  • vision problems
  • confusion
  • dizziness
  • a sudden headache

A spinal stroke is caused by a disruption in the blood supply to part of the spinal cord. Most of the time, this is a result of a narrowing of the arteries (blood vessels) that supply blood to the spinal cord. The narrowing of the arteries is called atherosclerosis. Atherosclerosis is caused by a buildup of plaque.

The arteries typically narrow and weaken as we age. However, people with the following conditions are at a higher risk of having narrow or weakened arteries:

People who smoke, have a high alcohol intake, or don’t exercise regularly are also at risk.

A spinal stroke can be triggered when a blood clot blocks off one of the arteries supplying the spinal cord. A blood clot can form anywhere in the body and travel in the bloodstream until it gets stuck in an artery that has been narrowed due to plaque. This is referred to as an ischemic stroke.

A smaller percentage of spinal strokes occur when one of the blood vessels supplying the spinal cord bursts open and starts bleeding. The cause of this type of spinal stroke, also called a hemorrhagic stroke, is high blood pressure or an aneurysm that bursts. An aneurysm is a bulge in the wall of the artery.

Less commonly, a spinal stroke may be a complication of the following conditions:

  • tumors, including spinal chordomas
  • vascular malformations of the spinal cord
  • injury, such as a gunshot wound
  • spinal tuberculosis or other infections around the spinal cord, like an abscess
  • spinal cord compression
  • abdominal or heart surgery

A spinal stroke in a child is exceedingly rare. The cause of a spinal stroke in children is different from those in adults. Most of the time, a spinal stroke in a child is caused by either an injury to the spinal cord or a congenital condition that causes problems with the blood vessels or affects blood clotting. Congenital conditions that may cause spinal strokes in children include:

  • cavernous malformations, a condition that causes small clusters of abnormal, enlarged blood vessels that periodically bleed
  • arteriovenous malformations, an abnormal tangle of vessels in the brain or spinal cord
  • moyamoya disease, a rare condition causing certain arteries at the base of the brain to be constricted
  • vasculitis (inflammation of the blood vessels)
  • clotting disorders
  • lack of vitamin K
  • infections, such as bacterial meningitis
  • sickle cell anemia
  • umbilical artery catheter in a newborn
  • a complication of heart surgery

In some cases, the cause of the spinal stroke is unknown.

It can be hard to diagnose a spinal stroke because the initial symptoms can indicate a number of other conditions.

For this reason, at the hospital, a doctor will likely ask about your medical history and perform a physical exam in order to rule out other conditions that could be putting pressure on the spinal cord, like a slipped disc, tumor, or an abscess.

If your doctor suspects a problem with the spinal cord, they will likely have you do a magnetic resonance imaging scan, commonly referred to as an MRI.

However, there are cases when a spinal stroke does not show up on an MRI image, which means that spinal strokes are more likely to be diagnosed quite late.

Treatment is aimed at treating the cause of the spinal stroke and reducing symptoms, for example:

  • To treat a blood clot, you may be prescribed medications known as antiplatelet and anticoagulant drugs, such as heparin and warfarin (Coumadin). These drugs reduce the chance of another clot forming.
  • For high or low blood pressure, you may be prescribed a medication that normalizes your blood pressure.
  • If the spinal stroke was caused by a tumor, corticosteroids are used to reduce the swelling. The tumor will be removed surgically.
  • If you become paralyzed or lose sensation in certain parts of your body, you may require physical and occupational therapy to preserve the function of your muscles.
  • If you have bladder incontinence, you may need to use a urinary catheter.

If you smoke, you will likely be asked to quit. To improve your blood pressure and cholesterol levels, you should also eat a balanced and healthy diet rich in fruits, vegetables, and whole grains.

Complications depend on which part of the spinal cord is affected. For example, if the blood supply to the front of the spinal cord is reduced, your legs can be permanently paralyzed.

Other complications include:

  • breathing difficulties
  • permanent paralysis
  • bowel and bladder incontinence
  • sexual dysfunction
  • neuropathic pain
  • pressure sores due to loss of sensation in certain parts of the body
  • muscle tone problems, such as spasticity (uncontrolled tightening in the muscles) or lack of muscle tone (flaccidity)
  • depression

The recovery and overall outlook depend on how much of the spinal cord is affected and your overall health.

However, it’s possible to make a full recovery over time. Many people won’t be able to walk for a while after a spinal stroke and will need to use a urinary catheter.

A variety of research studies show that approximately 40-42 percent of people will show improvement in their symptoms following a spinal cord stroke. The degree and pace of improvement may vary.

What happens when you have a spinal stroke?

If you have a spinal stroke, it means the blood supply to a section of the spinal cord is decreased or cut off. This means the spinal cord can’t get oxygen and nutrients.

Can you survive a spinal stroke?

A spinal cord stroke is a life threatening condition with an approximate mortality rate of 9%. However, this does mean that the vast majority of people survive a spinal cord stroke.

How rare is a spinal stroke?

A spinal cord stroke is extremely rare. Research shows that only about 0.3-1 percent of all strokes are spinal strokes.

A spinal cord stroke happens when the blood supply to a part of the spinal cord is cut off or if a blood vessel impacting a part of the spinal cord has burst. This is different than a brain stroke, where the impact is on the brain.

Spinal cord strokes are very rare but can be very serious. In some cases, they can cause major complications such as paralysis.

However, many people who experience a spinal stroke can recover and see significant improvement in their symptoms over time.