Hematomyelia due to
anterior spinal artery aneurysm in a patient with coarctation of aorta.
Case 1A-A 57-year old female, M.B., with acute onset; the symptoms develop within minutes and mimic an
anterior spinal artery syndrome: paraplegia, total sensory loss, urinary retention, bowel incontinence.
The vessels of the anterior horn cells i-e the
anterior spinal artery shows chronic microcirculatory changes histopathologically due to constant compression on flexion.8-10 As being described above this is due to anteriorly displaced lower cervical thecal sac in flexion resulting in atrophic asymmetric flattened cord.1,9-11 So Hirayama disease is a clearly recognized unique disease exclusively different from the typical pattern of motor neuron disease.
(10) Originating from the vertebral arteries, (10) the single
anterior spinal artery supplies the anterior third of the spinal cord, including the central grey matter and anterolateral white matter, while the paired posterior spinal arteries supply the posterior third, including the posterior columns (Figure 5).
Brownlee concluded that there had been an injury to the victim's
anterior spinal artery.