A stroke doesn't always happen in the brain; it can also occur in the spine. When blood flow to the spinal cord is interrupted, the effects can be sudden and life changing.
When you hear the word “stroke,” you may think of an event that occurs in the brain. However, a stroke can also occur in the spinal cord. Though rare, spinal strokes can have life-changing effects on movement, sensation and independence.
A spinal stroke, also known as a spinal cord infarction, occurs when the blood supply to the spinal cord is disrupted or blocked. Without oxygen and nutrients, spinal cord tissue can become damaged. This can interfere with communication between the brain and the rest of the body. Unlike a stroke that occurs in the brain, a spinal stroke only affects movement and sensation at or below the level of the stroke.
Sydney Smith, a senior physical therapist at Encompass Health Rehabilitation Hospital of Littleton, said that spinal strokes are rare and account for 1% to 2% of all strokes.
What causes a spinal stroke?
One of the most common causes of a spinal stroke is a condition affecting the aorta, such as an aneurysm or an aortic dissection. Because the aorta is the body's main artery, changes can directly impact how much oxygen-rich blood reaches the spinal cord.
While spinal strokes are uncommon, several conditions can increase the risk, including:
- Low or high blood pressure
- Blood vessel abnormalities
- Diabetes
- Heart disease
Types of spinal stroke
Not all spinal strokes happen the same way. The type of spinal stroke depends on what disrupts blood flow to the spinal cord.
There are two main types of spinal strokes:
Ischemic spinal stroke is the most common type of spinal stroke. It occurs when a blood vessel in the spinal cord becomes blocked, often by a blood clot.
Hemorrhagic spinal stroke occurs when a blood vessel in or around the spinal cord ruptures or bleeds. The bleeding reduces blood flow and causes pressure and swelling around the spinal cord, which can further damage nerve tissue.
Is a spinal stroke different from a brain stroke?
Yes, a stroke that occurs in the spine is different from one that happens in the brain. Although both conditions are caused by a disruption in blood flow, they affect different parts of the nervous system and can cause different symptoms.
A brain stroke happens when blood flow to the brain is disrupted or a blood vessel ruptures, resulting in brain tissue damage. This can affect communication, vision, memory and mobility.
A spinal stroke occurs when blood flow to the spinal cord is blocked or interrupted, damaging the nerve pathways that allow communication between the brain and the rest of the body.
As a result, symptoms can vary significantly between a spinal stroke and a brain stroke.
Signs and symptoms of a spinal stroke
When a spinal stroke occurs, every minute matters. Symptoms often appear suddenly and can worsen over time.
Because the spinal cord carries signals between the brain and the body, a disruption in blood flow can quickly affect movement, balance and coordination below the affected area.
Common spinal stroke symptoms may include:
- Sudden weakness in the legs or arms
- Difficulty walking or maintaining balance
- Loss of sensation, including reduced ability to feel temperature, touch or pain
- Back pain or neck pain
- Changes in bladder or bowel function
"A spinal stroke is going to affect someone from the location of the stroke in the spine downward, meaning it could affect the upper and lower body or just the lower body," Smith said. "Individuals may notice weakness or paralysis from the lower back down to their toes.”
Emotional recovery after a spinal stroke
A spinal cord stroke can cause significant emotional distress, especially when it happens suddenly and affects mobility and independence. Many people experience fear, grief, frustration or anxiety as they begin to process what has happened. Family members may also feel overwhelmed and uncertain about how to help.
"Emotional stress kind of comes and goes in waves, at least from what I've experienced," Smith said. "Many individuals are shocked or in disbelief, especially because of the stress that comes with such a significant life change."
Can you have a second spinal stroke?
Smith said a second spinal stroke is possible, although spinal strokes are rare. The risk depends on the underlying cause of the first stroke and whether contributing health conditions are effectively managed. Common risk factors include cardiovascular disease, diabetes and blood vessel abnormalities.
Rehabilitation after a spinal stroke
Stroke rehabilitation can play a critical role in recovery after a spinal stroke by providing intensive therapy and 24/7 nursing care. Patients and caregivers also receive resources and education to help them navigate recovery and prepare for life at home.
“After a spinal stroke, inpatient rehabilitation is a great way to help patients regain as much function and independence as possible,” Smith said.
In an inpatient rehabilitation setting, individuals will work with physicians, nurses, therapists and other specialists to regain strength, improve mobility, relearn daily activities and work toward greater independence and quality of life.
