New diagnostic criteria for spontaneous spinal cord infarcti
In a recently published study in JAMA Neurology, the authors have proposed new diagnostic criteria combining clinical history, cerebrospinal fluid (CSF) analysis, and neuroimaging have been proposed to improve the diagnosis of spontaneous spinal cord infarction (SCI).

SCI is often disabling, and the diagnosis can be challenging without an inciting event (eg, aortic surgery). Patients with a spontaneous SCI are often misdiagnosed as having transverse myelitis. Diagnostic criteria for SCI are lacking, hindering clinical care and research.

Investigators compared the medical records of 133 patients diagnosed with spontaneous SCI to those of patients with alternative myelopathy etiologies. Based on this comparison, they propose spontaneous SCI be diagnosed in the setting of:

• Clinical signs and symptoms: Acute, nontraumatic myelopathy symptoms which develop within 12 hours or sooner

• MRI findings including no spinal cord compression; intramedullary T2-hyperintense spinal cord lesion (supportive finding); and one of the following: diffusion coefficient restriction, associated vertebral body infarction, or arterial dissection/occlusion adjacent to the lesion

• Noninflammatory CSF

• No likely alternative diagnoses

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