“Eye and Spinal Strokes: Symptoms and Treatments”

Sudden, painless loss of vision in one eye. back pain that seems to cut off. leg pain. Urinary incontinence… . Some of these symptoms could be symptoms of a stroke, the American Heart Association News (AHAN) reported on the 19th (local time).

Matthew Schrag, a neurology professor at Vanderbilt University University Hospital in the United States, said strokes can occur in other parts of the body. Sudden loss of vision in one eye is likely an eye stroke, while loss of ability to sense temperature along with back pain, leg pain and urinary incontinence may be a spinal stroke.

The American Heart Association (AHA) and American Stroke Association (ASA) define a stroke as loss of blood supply to the brain, spinal cord, and retina, resulting in cell death. A stroke to the brain can cause symptoms such as facial paralysis, weakness in an arm or leg, especially on one side of the body, difficulty speaking or understanding speech, problems with vision, lack of coordination, or a sudden, severe headache. However, Lucia Sovrin, a professor of ophthalmology at Harvard Medical School, said that a stroke can be seen when the blood supply is disrupted almost anywhere in the body.

An eye stroke, also known as central retinal artery occlusion (CRAO), occurs when plaque that builds up on the carotid arteries on either side of the neck, which normally carry blood to the brain and eyes, breaks off and travels to the retina. When the same plaque migrates to the brain, it causes an ischemic stroke. “It could go either way,” he said.

CRAO usually results in complete loss of vision in one eye, but in some cases only partial loss of vision may occur. Even if vision loss occurs, you can still perceive light or motion, Professor Sovrin explained.

CRAO is not fatal, but if not treated within the first few hours, vision loss can be permanent, Schrag explained. “If you suddenly lose your sight and there is no pain, you should go to the emergency room thinking it’s a ‘stroke’,” he said.

The two professors were co-authors of the 2021 AHA Scientific Statement advocating immediate screening and treatment of CRAO with alteplase, a drug used to dissolve stroke-causing blood clots in the brain. Several studies have shown a 50% recovery rate in CRAO patients treated with alteplase within 4½ hours of vision loss.

Another reason to seek treatment right away when CRAO occurs is for signs of a serious underlying medical condition. Schrag said CRAO is a strong predictor of future heart attacks, strokes or death. The AHA statement urges CRAO to be screened for other cardiovascular risk factors that require treatment, including hypertension, hypercholesterolemia, diabetes, sleep apnea and obesity.

Little is known about treatments for rare but dangerous spinal strokes, Schrag said. A spinal stroke can be caused by a blood clot in an artery leading to the spine. Treatment depends on the individual’s symptoms and may include blood thinners to reduce clotting.

A spinal stroke can also occur during a medical procedure if blood pressure drops rapidly or the heart stops and blood flow is not sufficient. “The solution is to get the blood pressure back up before permanent damage occurs,” Schrag said.

In general, the same steps people take to prevent strokes of the brain are the same as those recommended to prevent strokes of the eye or spine. These include a healthy diet, maintaining physical activity, maintaining a healthy weight, not smoking, keeping blood pressure, blood sugar, and cholesterol within target ranges, getting 7 to 9 hours of sleep each night, and taking medications as needed as prescribed.