Table 1.

Summary of the major causes of vascular damage to the spinal cord; the sites of initial damage and the long-term consequences of that damage

		Initial damage	Consequences	Key references
Hypoxia caused by traumatic events	Acute spinal cord hypoxia	Traumatic accidents (e.g. car accidents, falls), surgery can cut temporarily blood flow to the spinal cord	Neural necrosis within 6 h and up to 34–48 after hypoxic episode. Long-lasting damage, normally irreversible	Richards et al.23, Gravereaux et al.24, Ahuja et al.25, Kato et al.26, Long et al.38
	Long-term spinal cord compression	Damage to the spinal cord can result in chronic compression of the spinal cord paired with a prolonged decrease of the blood supply	Decrease of vascular microvasculature. Slow neural damage, eventually irreversible (after 9 weeks)	Cheng et al.37, Long et al.38, Kurokawa et al.39, Kasahara et al.40
Hypoxia due to chronic disease	Vascular alterations	Vascular pathology (e.g. arteriovenous fistulas) can result in a prolonged decrease of the blood supply	Similar to spinal cord compression. Shown to be damaging to oligodendrocytes (demyelination)	Hurst et al.49, Larsson et al.50, Jellemaet al.51, Duncombe et al.54, Shibata et al.57
	Motor neurone disease and muscular sclerosis	Vascular anomalies have been detected in some neurodegenerative diseases (e.g. ALS, SMA), resulting in alterations of the normal blood supply	Neural damage and demyelination likely to be increased. Potential negative effect in neurone-focused treatments	Somers et al.61, Zhong et al.62, Nobutoki and Ihara63, Miyazaki et al.64, Davies et al.72, Desai et al. n.d., Hua et al.81