Aortic Dissection link to Spinal Cord Ischemia?

Can aortic dissection result in symptoms such as back pain, leg weakness, and loss of bladder or bowel control?
Yes, aortic dissection can potentially lead to these symptoms due to its impact on the spinal cord. The aorta and its branches supply blood to the spinal cord, and when a dissection occurs, it can disrupt the blood flow to this area. This disruption, known as spinal cord ischemia syndrome (SCIS), can cause damage to the spinal cord and result in various neurological symptoms.
In the thoracic region, where aortic dissection commonly occurs, the anterior spinal cord receives its blood supply from branches originating from the aorta. The anterior spinal cord houses motor nerve fibers to the legs, autonomic fibers controlling bowel and bladder function, and the anterolateral spinothalamic tract responsible for crude touch and pain sensation. Aortic dissection can interrupt the blood supply to the anterior spinal cord, leading to paralysis, bowel or bladder dysfunction, and loss of crude touch and pain sensation.
However, it's important to note that the posterior spinal cord, which includes the dorsal column responsible for fine touch, proprioception, and vibration sensation, is usually spared because it has a dual blood supply. This means that the symptoms related to these sensory functions may not be affected by aortic dissection.
Overall, the connection between aortic dissection and the symptoms of back pain, leg weakness, and loss of bladder or bowel control lies in the potential damage to the anterior spinal cord caused by the disruption of blood flow during the dissection.

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