The understanding of ischemic spinal cord infarction in children is an evolving area in pediatric neurology. Even as the causes become better characterized in children, our cases demonstrate the continued difficulty in diagnosis. The outcome of spinal cord infarction is difficult to change after the insult. Improvement in treatment requires more rapid and exact diagnosis, with both axial and sagittal T1, T2 and diffusion-weighted
MRI of the spinal cord to visualize both intrinsic and extrinsic lesions in suspected cases. Angiography, to assess for vascular occlusion and arteriovenous malformation, may be indicated in some cases. Thrombotic evaluation plays an important role in diagnosis, because thrombotic disorders can be medically treated. As MRI becomes more sensitive, and as new modalities of neuroimaging become available, we expect the diagnosis of spinal cord infarction to become better characterized and hopefully easier to manage. It is important to recognize and address the varied physical and psychosocial complications of spinal cord infarction in order to optimize outcome.