Vascular
Obstruction of the artery of Adamkiewicz that feeds the anterior spinal artery (usually due to atherosclerosis) will cause an infarction of the cord. Typically, severe back pain and flaccid paralysis with pain and deficiency in temperature sensation will develop within minutes or hours.55 Level D2-4 will usually be the affected sensory level. Vibration and proprioception will be relatively preserved due to a different blood supply to the posterior cord. Arteriovenous malformations can be small or large, and either asymptomatic or cause radicular symptoms or sudden pain with various neurological problems due to bleeding.56 An aggressive spinal hemangioma can grow out of the vertebral body into the spinal canal, compress the cord and spinal roots, and cause symptoms accordingly. It typically appears in young adults and worsens during pregnancy.57 An epidural or subdural hematoma of the spine appears after trauma, epidural injection, coagulation abnormalities, and thrombolytic therapy and causes the sudden appearance of pain with various neurological problems up to complete paraplegia within minutes or hours.58 Wegener granulomatosis is a systemic necrotizing granulomatous vasculitis. Neurologic symptoms mostly include peripheral neuropathy and mononeuritis multiplex, with rare cases of meningeal involvement. Cervical spinal cord compression leading to myelopathy has also been reported.59