What Is a Spinal Stroke?

Written by Marijke Vroomen Durning, RN
Medically Reviewed by Melinda Ratini, MS, DO on August 12, 2025
10 min read

Your spinal cord needs a steady blood supply to deliver oxygen and nutrients to the tissues. This blood helps the spinal cord cells send nerve impulses to the rest of your body. The impulses are signals or messages that help you with vital yet basic body movements, such as moving your arms and legs, and make sure your organs, such as your heart and intestines, work as they should. 

If the blood flow in your spinal cord is blocked, it can lead to a spinal stroke (also called a spinal cord stroke or spinal cord infarction).

A blockage to the spinal cord might be caused by a blood clot or an injury (called an ischemic spinal stroke) or a bleed (hemorrhagic spinal stroke). Although spinal strokes are rare, they are a medical emergency and need immediate attention. A spinal stroke can be life-threatening, leading to death. For survivors, the stroke can leave behind life-altering health problems.

How does a spinal cord stroke differ from other strokes?

The type of stroke most people have likely heard of affects the brain. It’s also called a cerebrovascular accident (CVA). The cause of a CVA is the same as a spinal stroke — either blood flow is blocked or there’s a break or tear in a blood vessel, causing bleeding. The difference between the two types of strokes is where the blockage or bleeding takes place in the body and how common they are.

With brain strokes, a blood vessel in your brain becomes blocked or broken. With a spinal stroke, the block or break happens in your spinal cord.

Brain strokes are much more common than spinal strokes. Every year, almost 800,000 people in the U.S. have a brain stroke, and almost 90% of them are ischemic strokes. 

But spinal strokes are very rare. Research says about 1% of all strokes are spinal strokes. Even this small percentage may be an overestimation, says Constance V. Katsafanas, DO, neurologist and director of the Neurology Residency Program at Marcus Neuroscience Institute. “In my years of practice, I’ve seen a handful of them, definitely less than 10,” she says.

The most common symptom of a spinal stroke is sudden weakness or loss of feeling in both legs, but this can also happen in your arms. Sometimes, people feel these symptoms only on one side of the body. Then, within minutes to a few hours, other spinal stroke symptoms can appear, including: 

  • Sudden, intense pain in your neck or back (over 80% of people have pain)
  • Arm or leg pain radiating from your back
  • Muscle weakness in your hands, but more commonly in the legs
  • Numbness, burning, or tingling sensations in your arms or legs
  • Loss of temperature sensation of objects or water
  • An uncontrollable need to urinate or move your bowels (incontinence)
  • Full or partial paralysis 
  • Sexual problems (dysfunction)
  • Changes in blood pressure
  • Trouble breathing

If you or your loved one notices any of these symptoms, get medical help right away. Call 911. If you’re the one going through the symptoms, do not drive yourself to the hospital because your symptoms could worsen very quickly, making driving dangerous.

There are two types of spinal strokes, and they have different causes. 

Ischemic spinal strokes

Ischemic strokes, the most common type, are most often caused by blood clots. You’re more likely to have this type of spinal stroke if you have atherosclerosis. This happens when the walls of your arteries, which carry blood from your heart to provide oxygen and nutrients to your body’s tissues, become thick or too narrow for steady blood flow to your spinal cord. This is usually caused by plaque, a buildup of fat, blood cells, and other substances attaching to the artery wall. 

Other possible causes include:

Although rare, some other possible causes for ischemic spinal stroke include:

  • Spinal cord injury
  • Spinal fractures
  • Meningitis and some other infections

Hemorrhagic spinal strokes

If you have a hemorrhagic spinal stroke, this could be caused by:

The causes for spinal strokes among children and adults are typically different. Adults who have a spinal stroke often have heart disease or chronic illnesses such as diabetes. But for children, the strokes are most often caused by heart abnormalities or trauma.

Spinal strokes can happen at any age, but they seem to happen most often to people who are in their 50s and 60s. Certain health conditions, lifestyle habits, and medical conditions can raise your risk of having a spinal stroke, such as:

  • Aortic disease, including aortic aneurysm and rupture, aortic dissection (the aortic wall tears), aortic valve stenosis (valve doesn’t open properly), and aortic occlusion (blockage)
  • High blood pressure (hypertension)
  • High cholesterol
  • Smoking tobacco
  • Diabetes
  • Spinal degenerative disease
  • Having an epidural or spinal anesthesia
  • Blood clotting disorders
  • Using cocaine
  • Lack of physical exercise
  • Drinking too many alcoholic beverages

A spinal stroke is a medical emergency. Early diagnosis and treatment may limit damage from the stroke. 

Along with getting your medical history, including any serious spinal cord symptoms that developed in the past 12 hours, an emergency department doctor or a neurologist (specialist in the nervous system, including the brain and spinal cord) will do a physical and neurological exam. A neurological exam looks at your reflexes, if you can stand and walk, and how well you can feel things on your hands, arms, and legs. 

For an accurate diagnosis, your doctor may:

  • Order an MRI scan or a CT scan, which will give a closer look at your spine
  • Do a lumbar puncture (spinal tap) to check for inflammation in your spinal fluid
  • Run more tests such as an echocardiogram to check your heart and blood tests to rule out other possible causes for your symptoms

How do doctors differentiate between ischemic and hemorrhagic spinal strokes?

Doctors can tell the difference between ischemic and hemorrhagic spinal strokes by the MRI results. But CT scans are easier and faster to get, so they often rely on those. A CT scan can show if there is blood in the spine, so they can diagnose a hemorrhagic stroke. But the scan can’t identify if you’ve had an ischemic stroke, Katsafanas says. This is where a clinical diagnosis comes in, particularly if an MRI isn’t possible. If the patient is showing signs and symptoms of a spinal stroke and there are no signs of there being blood, it’s likely an ischemic spinal stroke.

It’s essential the doctors find out what type of stroke has affected you because the treatment is very different. Blood thinning drugs, given for ischemic strokes, can’t be given if someone has had a hemorrhagic stroke.

Your treatment plan depends on the cause of the stroke and damage from the stroke. The most important, immediate, goal is to return blood flow to your spinal cord as quickly as possible. After that, your doctors can focus on managing the symptoms that are left from the damage caused by the stroke, what might have caused the stroke in the first place, and rehabilitation.

When is surgical intervention necessary?

If you’ve had an ischemic stroke, your doctor might opt to surgically remove the blood clot from your artery. This is called a surgical thrombectomy. To do this, a surgeon makes an incision, or cut, near the affected blood vessel to remove the clot. 

Another procedure, called a percutaneous thrombectomy, is a minimally invasive procedure. To do this, the doctor threads a catheter (a long, flexible tube) to the blocked section of the artery. Then using a tiny tool at the end of the catheter, the doctor breaks down or uses suction to remove the clot.

For hemorrhagic spinal strokes, a surgeon might have to do emergency surgery to ease the pressure the blood is placing on your spine or an embolization procedure to stop the bleeding. This involves inserting a very thin catheter into the blood vessel to reach the bleed.

What medications may be used in managing spinal strokes?

If you’ve had an ischemic stroke, your doctor might prescribe:

  • Blood-thinning drugs such as warfarin to clear blood clots and keep more from forming; other drugs, such as aspirin, which may make your blood less sticky and thick, reducing the risk of more clots
  • Drugs to help with stroke symptoms such as muscle stiffness, bladder or gut issues, and sexual dysfunction

If you’ve had a hemorrhagic stroke, your doctor needs to stop the bleeding. Some medications that could help with this include:

After the emergency

Once the emergency is over, your doctor will want you to lower your risk factors to reduce the risk of having another spinal stroke. This may mean taking:

  • Drugs called statins that can lower your cholesterol 
  • Antihypertensive medications to lower your blood pressure
  • Diabetes medications

If you continue to have muscle weakness or paralysis when you’re recovering, your doctor will typically recommend physical therapy and/or occupational therapy to help you:

  • Improve your balance
  • Regain use of your arms and legs
  • Learn how to complete daily activities, with special adaptations and tools if needed

If you have bladder issues, you might need a catheter — a flexible tube inserted through your urethra to your bladder so urine can drain out.

Recovery from a spinal stroke differs between people because it depends on the type of stroke you had, how much damage it caused, and your overall health before you had the stroke. 

About 20%-25% of people who have a spinal stroke die within the first month of symptom onset, but this is often because they also had other health issues. Or, they develop complications from the stroke. Someone who has had a spinal stroke could develop pneumonia or pressure sores (bedsores) that could become infected, for example.

Statistics show that less than 10% of people with a spinal stroke can walk after the stroke. But according to Katsafanas, this statistic is for people who can walk alone without help. If you take into account being able to walk with a cane or other assistive device, the percentage of people who can move around is higher. Getting good rehabilitation with physical therapists can go a long way toward recovery.

Other long-term effects that can come with having a spinal stroke include:

  • Paralysis
  • Physical disability 
  • Muscle weakness
  • Problems with going to the bathroom
  • Sexual dysfunction
  • Joint pain 
  • Depression 
  • Breathing problems

If you or a loved one is showing signs of a spinal stroke, it’s a medical emergency. Call 911.

How can spinal stroke be prevented?

It might not be possible to avoid a spinal stroke, especially if it happens after a trauma or because of a heart defect. But if you have any of the risk factors that can be controlled, you may be able to lower your spinal stroke risk. This means:

  • Stop smoking
  • Follow a healthy diet, limiting processed and fatty foods
  • Maintain a healthy weight
  • Manage chronic illnesses, such as hypertension and diabetes (Half of people with spinal stroke have diabetes.)
  • Be physically active

Spinal strokes are a rare type of stroke, but like the more common ones that affect the brain, spinal strokes are a medical emergency. The earlier a spinal stroke is diagnosed and treated, the better the chances of a good outcome. “I tell people all the time, if you’re wondering if you’re having a stroke, the answer is go to the hospital,” Katsafanas says. Recovery is possible for many survivors, but it may take a lot of rehabilitation.

Can you recover from a spinal cord stroke?

Yes, you can get better from a spinal stroke. While not everyone gets well from a spinal stroke, many do. How much health someone gets back depends on how serious the stroke was and how quickly it was treated. A spinal stroke is a medical emergency, and the shortest time to treatment is very important. Afterward, rehabilitation services, such as physical therapy and occupational therapy, also raise the chances of a good recovery.

Can a person walk after a spinal stroke?

Some people (less than 10%) can walk again independently after having a spinal stroke. It depends on how much damage the stroke caused. Others must use canes or other walking aids after a spinal stroke, and many must use a wheelchair after.

Is a spinal stroke life-threatening?

Yes, a spinal stroke can be life-threatening, especially if the stroke happens higher up in the spine. Up to 25% of people who have a spinal stroke die within a month of beginning symptoms, often from complications related to the stroke but not necessarily the stroke itself.