Priapism in acute spinal cord injury.
Summary of "Priapism in acute spinal cord injury."
Study design:Prospective literature review; search via Oldmedline (1958-1965), Medline (1966-2005) and Pubmed.Objectives:The objective of this study is to review the pathophysiology of priapism in acute traumatic spinal cord injury (SCI); to determine the incidence of priapism in traumatic SCI, whether or not priapism is associated with incomplete or only complete SCI and whether and what treatment might be required.Methods:This is a review article based upon the available literature in this area.Results and conclusions:Priapism that follows acute traumatic SCI is high-flow (non-ischaemic) priapism, that is, the blood within the corpus is arterial in nature. Priapism does not occur in all patients with acute SCI. The literature does not allow us to determine in what proportion of patients priapism occurs. Priapism has been reported following a wide variety of spinal cord pathologies including acute SCI, transverse myelitis and postoperative extradural haematoma. In all patients, priapism is associated with complete motor and sensory (American Spinal Injury Association A) paraplegia. Priapism has been reported following spinal shock. Following traumatic SCI, priapism usually settles rapidly without specific treatment being required. Priapism occurs at the moment of complete motor and sensory paraplegia, it does not occur following a delay. There are medicolegal implications: the presence/absence of priapism assists in determining when the complete spinal cord lesion occurred.Spinal Cord advance online publication, 7 June 2011; doi:10.1038/sc.2011.57.
Regional Neurosciences Centre, Royal Victoria Infirmary, Newcastle upon Tyne, UK.
This article was published in the following journal.
Name: Spinal cord
Medical and Biotech [MESH] Definitions
Spinal Cord Regeneration
Repair of the damaged neuron function after SPINAL CORD INJURY or SPINAL CORD DISEASES.
Central Cord Syndrome
A syndrome associated with traumatic injury to the cervical or upper thoracic regions of the spinal cord characterized by weakness in the arms with relative sparing of the legs and variable sensory loss. This condition is associated with ischemia, hemorrhage, or necrosis involving the central portions of the spinal cord. Corticospinal fibers destined for the legs are spared due to their more external location in the spinal cord. This clinical pattern may emerge during recovery from spinal shock. Deficits may be transient or permanent.
Spinal Cord Diseases
Pathologic conditions which feature SPINAL CORD damage or dysfunction, including disorders involving the meninges and perimeningeal spaces surrounding the spinal cord. Traumatic injuries, vascular diseases, infections, and inflammatory/autoimmune processes may affect the spinal cord.
Spinal Cord Ischemia
Reduced blood flow to the spinal cord which is supplied by the anterior spinal artery and the paired posterior spinal arteries. This condition may be associated with ARTERIOSCLEROSIS, trauma, emboli, diseases of the aorta, and other disorders. Prolonged ischemia may lead to INFARCTION of spinal cord tissue.
Anterior Spinal Artery Syndrome
Ischemia or infarction of the spinal cord in the distribution of the anterior spinal artery, which supplies the ventral two-thirds of the spinal cord. This condition is usually associated with ATHEROSCLEROSIS of the aorta and may result from dissection of an AORTIC ANEURYSM or rarely dissection of the anterior spinal artery. Clinical features include weakness and loss of pain and temperature sensation below the level of injury, with relative sparing of position and vibratory sensation. (From Adams et al., Principles of Neurology, 6th ed, pp1249-50)
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