Spinal cord injury vs spinal cord stroke. What is the difference?
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A spinal cord injury and a spinal cord stroke are two different medical events
Differences between a spinal cord injury and a spinal cord stroke
- A spinal cord injury (SCI) is mechanical damage to the spinal cord, most often resulting from physical trauma such as a car accident, a fall or a sports injury. It leads to structural damage to the cord, which can cause varying degrees of loss of sensation, movement and organ function, depending on the level of the damage.
- A spinal cord stroke is far rarer than a spinal cord injury. It results from a sudden interruption of blood flow in the spinal cord or its vessels, much as happens in an ischaemic stroke of the brain. The causes may include thrombosis of the spinal arteries, embolism of the spinal arteries or vascular injury. Reduced blood flow leads to ischaemia and damage to the nerve tissue of the cord.
Deficits after a spinal cord injury depending on whether the cord has been severed
The deficits associated with a spinal cord injury can differ depending on whether the cord has been completely severed or the damage is partial. Here are the general differences in each case:
Spinal cord injury with a severed cord (complete transection)
- Spastic paralysis: with a complete transection of the spinal cord above a given segment, control over movement below the level of the damage is lost. This often leads to spastic paralysis, with high muscle tone, stiffness and difficulty controlling movements.
- Loss of sensation: patients with a complete transection of the cord lose sensation below the level of the damage, so they do not feel touch, pain or temperature.
- Dysfunction of internal organs: a severed cord can lead to problems with breathing, bladder and bowel control, and sexual dysfunction.
Spinal cord injury without a severed cord (partial damage)
- Flaccid paralysis: with partial damage to the cord, patients often experience muscle weakness and flaccid paralysis, but usually retain some degree of control over movement.
- Partial loss of sensation: below the level of the damage there may be an incomplete loss of sensation. The patient feels some stimuli, but the ability to feel is often clearly limited.
- Possible partial internal organ function: depending on the level and severity of the damage, some internal organ function may remain, although significant difficulties are still present.
It is worth noting that the specific range of deficits can vary depending on the level of the spinal cord damage. Damage in the higher segments usually leads to a greater loss of function than damage in the lower segments.
Classification of deficits according to the level of damage
Below we present a general breakdown of the possible motor deficits and limitations according to the level of the spinal cord damage. The specific symptoms may, however, differ depending on the individual characteristics of the patient and the severity of the injury.
- Damage in the cervical region (C1–C7): can lead to tetraplegia — that is, loss of function in both the upper and lower limbs — as well as impaired sensation and internal organ function below the level of the injury. In such situations, rehabilitation of the affected hand and upper limb becomes particularly important.
- Damage in the thoracic region (T1–T12): most often leads to paraplegia. The patient retains control over the upper limbs but loses part of the motor and sensory function of the lower limbs, which makes therapy for gait and balance disorders one of the main goals of rehabilitation.
- Damage in the lumbar region (L1–L5): can also lead to paraplegia, though it usually allows greater independence in getting around than damage to the higher segments.
- Damage in the sacral region (S1–S5): usually causes motor limitations in the lower limbs and difficulty walking and controlling leg movements.
Regardless of the level of the damage, patients may experience varying degrees of internal organ dysfunction, such as problems with breathing, bladder and bowel control, and sexual dysfunction.
It is worth emphasising that the range of deficits and motor limitations depends on individual factors such as the severity of the damage, the course of rehabilitation and progress in recovery. That is why every patient after a spinal cord injury needs personalised medical and rehabilitation care, including specialist training such as suspension-based rehabilitation on the PAJĄK (Spider Therapy device).
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