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May 15, 1937


JAMA. 1937;108(20):1698-1701. doi:10.1001/jama.1937.02780200020005

The clinical diagnosis of acute transverse myelitis or hematomyelia is frequently made in cases of acute paraplegia or quadriplegia in which at autopsy the cord shows an extensive softening. The myelomalacia may be due to a thrombosis of the anterior spinal artery or to an occlusion of some other vessel or vessels of the spinal cord. Very often there is no microscopic evidence of inflammation or hemorrhage into the cord substance. In many cases the thrombosed vessel is found to be thickened and infiltrated with inflammatory cells, having the appearance of syphilitic arteritis. Most of these cases do not give a history of an injury. However, several cases have been reported of acute paralysis of spinal cord origin due to myelomalacia following a trivial trauma such as a strain. Ornsteen1 stresses the fact that in diagnosing thrombosis of the anterior spinal artery the absence of direct and violent trauma