No author information is available for this submission.
The authors are in the process of completing this submission.
Please try again later.
Authors: Matthias Linke DO1, Aaron Bolds MD1, Miquel Escalon MD, MPH1, 1Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai
Background: Is Sickle Cell Trait (SCT) benign? There is a debate in Neurology whether sickle cell trait is a risk factor in early stroke; with increased sickling rates with dehydration, oxygen reduction, and exercise leading to strokes.1,2 The detrimental effects of sickle cell trait has also caused the sudden deaths of some young athletes 2,3. We report only the second case of a spinal cord infarction of an individual with SCT in order to bring more attention to this disease.
Methods: The medical record was reviewed from a 21 year old male with SCT who developed an anterior spinal cord infarction for risk factors to determine the cause for the infarction.
Results: The patient developed a severe unrelenting headache at 6 am on June 2016. The patient was found down by his mother at 9 am with acute tetraplegia. The patient underwent neurological evaluation including MRI and MAR. Imaging was consistent with an anterior spinal artery stroke affecting the anteromedial medulla and cervical spine. Hypercoagulable work-up was negative. The patient required mechanical ventilation with placement of tracheostomy and percutaneous enteral feeding tube. The patient stabilized medically but did not regain any motor function of his upper or lower extremities. He was weaned off the ventilator at a subacute facility. The patient is being followed in a SCI clinic with examination showing intact touch Light touch only and position sense, but paralyzed muscles in both upper and lower extremities. Family and social history incluseds a father who has sickle cell trait and the mother who does not. The patient was living with his parents until the time of his stroke and has been in a Skilled/Subacute Care facility since his infraction. Imaging studies showed a T2 Sagital MRI 2 days after onset of symptoms demonstrating T2 changes in the medulla and cervical spinal cord. T2 Sagital Axial MRI showing anterior spinal cord T2 changes
Conclusion: Sickle cell trait causes variable sickling with abnormal shaped hemoglobin S causing impaired blood flow.4,5 In our patient impaired blood flow affected the anterior portion of the spinal cord, which is supplied by the anterior spinal artery. Clinically the patient presents with an Anterior Spinal Syndrome spinal cord injury secondary to infarction of his anterior spinal cord resulting from hypercoagulable state due to Sickle Cell Trait. Sickle Cell Trait is a risk factor for infarctions, including of the spine, and should be considered during work up and treatment of persons that suffer a spinal cord infarct
Ask a Question
Get involved to find out more about this Presentation.
Create an Account or Log In to participate in the discussion
spinal cord injury
sickle cell trait
anterior spinal cord infarct
anemia, hemolytic, congenital
anemia, sickle cell
bacterial infections and mycoses
bone and bones
central nervous system
central nervous system diseases
congenital, hereditary, and neonatal diseases and abnormalities
environment and public health
genetic diseases, inborn
health care evaluation mechanisms
health care quality, access, and evaluation
hemic and lymphatic diseases
nervous system diseases
nutritional and metabolic diseases
otorhinolaryngologic surgical procedures
pathological conditions, signs and symptoms
quality of health care
signs and symptoms
statistics as topic
surgical procedures, operative
thoracic surgical procedures