Transverse Myelopathy in Childhood

CURRENT impressions and present-day pediatric texts generally regard transverse myelopathy as primarily an infectious process, that is to say, as so-called "transverse myelitis." There is considerable evidence, however, that a vascular etiology is actually involved in many, if not the majority of, cases, although in others the correlation with acute infections is too striking to be coincidental. The purpose of the present article is to present 25 cases of transverse myelopathy in childhood, and to consider their implications as to etiology, prognosis, and plan of management. The concept of a vascular basis for transverse myelopathy is actually not a new one; it was emphasized by Bastian1as early as 1886. Bastian subsequently proposed three possible causes for vascular thrombosis involving the spinal cord, namely, syphilis, arteriosclerosis, and infections (of the central nervous system or elsewhere).2This type of causation and the absence of leucocytic infiltration microscopically were also