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Genetic and Rare Diseases Information Center (GARD)

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Fibrocartilaginous embolism


Other Names for this Disease

  • Embolism, fibrocartilaginous
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.

Overview

What is a fibrocartilaginous embolism?

What causes a fibrocartilaginous embolism?

How is fibrocartilaginous embolism diagnosed?

How might fibrocartilaginous embolism be treated?

What is a fibrocartilaginous embolism?

A fibrocartilaginous embolism (FCE) is an unusual cause of spinal cord and cerebral ischemia (insufficient blood supply).[1] Symptoms may include sudden, severe pain in the neck and/or back; progressive weakening and reduced sensation; and paralysis.[2] It may be caused by the blocking of an artery (embolization) with nucleus pulposus fragments (a substance that provides cushioning to the spinal column), which interrupts the vascular supply. Some individuals have reported lifting, physical exertion, minor trauma, or Valsalva maneuver before severe spinal cord infarction. FCE can result in severe spinal cord injury or death in some individuals.[1]
Last updated: 3/24/2011

What causes a fibrocartilaginous embolism?

Fibrocartilaginous embolism (FCE) is a rare cause of spinal cord infarction (stroke). It is thought that a sudden vertical disk herniation of the nucleus pulposus material can lead to spinal cord infarction by backward movement of the material, disrupting the vascular supply and causing embolization in the artery.[3] Conditions resulting in high internal pressure, such as a Valsalva maneuver or trauma, may permit the abnormal backwards flow.[1] Some individuals have reported lifting, physical exertion, minor trauma, or Valsalva maneuver before severe spinal cord infarction.[1]
Last updated: 3/24/2011

How is fibrocartilaginous embolism diagnosed?

Initially, all cases of fibrocartilaginous embolism (FCE) were discovered at autopsy. In 1991, the first diagnosis of FCE was made in a patient who survived. Although there are no formal diagnostic criteria for FCE in a living individual, a number of authors have suggested specific features that make the diagnosis likely. These include minor trauma before the event, absence of vascular risk factors, spinal cord imaging consistent with an evolving infarction, normal cerebrospinal fluid (CSF) analysis, and the exclusion of other possible causes.[1]
Last updated: 3/24/2011

How might fibrocartilaginous embolism be treated?

Unfortunately, there is no cure for the symptoms associated with this condition. Common treatments for fibrocartilaginous embolism (FCE) have included intravenous steroids, intravenous heparin, and plasma exchange. However, no treatment has had a recognized impact on symptoms. The possibility that these treatments may have prevented further worsening or recurrence may still be considered.[1]
Last updated: 3/24/2011

References
  1. F. J. Mateena,b, P. A. Monradb, A. N. Leep Hunderfundb, C. E. Robertsonb and E. J. Sorenson. Clinically suspected fibrocartilaginous embolism: clinical characteristics, treatments, and outcomes. European Journal of Neurology. 2011; 18:218-225.
  2. Luigi Tosi, Gianfranco Rigoli, Alberto Beltramello. Fibrocartilaginous embolism of the spinal cord: a clinical and pathogenetic reconsideration. Journal of Neurology, Neurosurgery, and Psychiatry. 1996; http://www.ncbi.nlm.nih.gov/pmc/articles/PMC486190/pdf/jnnpsyc00013-0063.pdf. Accessed 3/23/2011.
  3. Han JJ, Massagli TL, Jaffe KM.. Fibrocartilaginous embolism--an uncommon cause of spinal cord infarction: a case report and review of the literature. Archives of Physical Medincine and Rehabilitation. January 2004; 85(1):153-157. http://www.ncbi.nlm.nih.gov/pubmed/14970983. Accessed 3/23/2011.


Other Names for this Disease
  • Embolism, fibrocartilaginous
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.