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Vascular Events After Spinal Cord Injury: Contribution to Secondary Pathogenesis

AEM Mautes, PhD, Head, Neurosurgical Research Laboratory, Saarland University Medical School, Homburg, Germany
MR Weinzierl, MD, Visiting Research Fellow, Department of Neurosurgery, University of California, San Francisco, Calif, and Medical Faculty, Department of Neurosurgery, University of Technology, Aachen, Germany
F Donovan, PhD, Postdoctoral Fellow, Department of Anatomy, University of California, San Francisco, Calif
LJ Noble, PhD, Professor, Department of Neurosurgery, University of California, C224, 521 Parnassus Ave, San Francisco, CA 94143-0520 (USA) (noblelj{at}itsa.ucsf.edu). Address all correspondence to Dr Noble

Traumatic spinal cord injury results in the disruption of neural and vascular structures (primary injury) and is characterized by an evolution of secondary pathogenic events that collectively define the extent of functional recovery. This article reviews the vascular responses to spinal cord injury, focusing on both early and delayed events, including intraparenchymal hemorrhage, inflammation, disruption of the blood-spinal cord barrier, and angiogenesis. These vascular-related events not only influence the evolution of secondary tissue damage but also define an environment that fosters neural plasticity in the chronically injured spinal cord.

Key Words: Blood-spinal cord barrier • Inflammation • Metalloproteinases • Spinal cord injury

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