2025 American Academy of Neurology Abstract Website

Ismail A. Ibrahim¹, Ahmed Hosney Nada², Nada Khalid Asar³, Rand Ibrahim⁴, Sarah A. Nada⁵, Rawan Ahmed Farouk⁶, Mostafa Meshref⁷
¹Faculty of Health Sciences, Fenerbahçe University, İstanbul, Turkey, ²Faculty of medicine Benha university, Egypt., ³Faculty of Medicine Mansoura UniversityEgypt., ⁴University of Aleppo, faculty of medicine., ⁵Faculty of medicine Menoufia university., ⁶faculty of medicine, Al-fayoum university, Egyp, ⁷Neurology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

Objective:

A systematic review and Meta-analysis was done aiming to study th Efficacy of Intra-Arterial and Intravenous Thrombolysis in Acute Spinal Cord Infarction.

Background:

Spinal cord disorders are one of the most serious clinical conditions that lead to variable severe symptoms from paralysis and muscle weakness to back pain. Spinal cord ischemia is a disorder that involves vascular pathology, and this condition can lead to spinal cord infarction. There is a lack of proven emergency treatment for spinal cord infarction it is most often only treated by supportive treatment like anticoagulation, intravenous immunoglobulins (IVIG), plasmapheresis, and thrombolytic therapy. Even if there is a limited understanding of this treatment's efficiency in spinal cord infarction and the risk of hemorrhage it has recently been successfully used in some incidents.

Design/Methods:

A comprehensive search strategy across multiple databases like PubMed, Cochrane, WOS, Embase, and Scopus was conducted, with inclusion criteria focusing strictly on case reports studies that reported the effect of thrombolysis on spinal cord infarction followed by data extraction and quality assessment.

Results:

In this study, a PRISMA flow diagram was used. 15 studies met the inclusion criteria, including a total of 18 patients who were all diagnosed with Spinal Cord Ischemia. Cases comprised 61.1% males, aged 17 to 83 (mean age 61). The diagnosis was primarily confirmed with MRI (14 out of 18 cases). Treatment strategies included thrombolytic therapy alone in 14 patients, and thrombolysis combined with other therapies in another 4 patients. The most common presenting symptoms were weakness and paraplegia. All patients showed gradual improvement with follow-up data in 10 of 12, indicating a good recovery (mRS 0-2).

Conclusions:

Thrombolytic therapy may be a potential therapeutic intervention for patients with spinal cord infarction, but further studies are needed to prove its efficacy.