Abstract
Background
Spinal cord infarction (SCI) is rare, accounting for approximately 1% of strokes.
Case Report
We present the case of a 63-year-old male who presented to the emergency department
(ED) with chest pain and acute-onset generalized weakness and was ultimately diagnosed
with SCI secondary to suspected occlusion of the artery of Adamkiewicz.
Why Should an Emergency Physician Be Aware of This?
SCI may present diagnostic challenges, with its predilection for mimicking other major
emergency conditions, such as acute aortic dissection, aortic aneurysm rupture, spinal
cord compressive myelopathy, or transverse myelitis. Its consequences are often significantly
disabling initially, though patients may experience subsequent clinical improvement.
It is important to include SCI in the differential for patients with chest or back
pain coupled with neurologic symptoms.
Keywords
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References
- Spinal cord infarction in clinical neurology: a review of characteristics and long-term prognosis in comparison to cerebral infarction.Eur Neurol. 2016; 76: 95-98
- Spinal cord infarction: report of 8 cases and review of the literature.Medicine. 1989; 68: 282-292
- Spinal cord infarction.N Z Med Student J. 2015; 20: 18-21
- Spinal cord infarction: etiology and outcome.Neurology. 1996; 47: 321-330
- Spinal cord ischemia: clinical and imaging patterns, pathogenesis, and outcomes in 27 patients.Arch Neurol. 2006; 63: 1113-1120
- Clinical biomarkers differentiate myelitis from vascular and other causes of myelopathy.Neurology. 2018; 90: e12-e21
- Evaluation of idiopathic transverse myelitis revealing specific myelopathy diagnoses.Neurology. 2018; 90: e96-e102
- Anterior spinal artery syndrome and its natural history.Paraplegia. 1983; 21: 1-10
- Anatomy, back, artery of Adamkiewicz.(StatPearls. Available at:)
- Clinical reasoning: a 59-year-old woman with acute paraplegia.Neurology. 2007; 69: E41-E47
- Ischemic myelopathy: a review of spinal vasculature and related clinical syndromes.Arch Phys Med Rehabil. 1992; 73: 365-372
- Diffusion-weighted MRI in acute spinal cord ischaemia.Neuroradiology. 2003; 45: 557-561
- Spinal cord infarction: clinical and magnetic resonance imaging findings and short term outcome.J Neurol Neurosurg Psychiatry. 2004; 75: 1431-1435
- Spinal cord infarction: clinical and radiological features.J Stroke Cerebrovas Dis. 2018; 27: 2810-2821
- Spontaneous thoracolumbar spinal cord infarction: report of six cases.Acta Neurol Scand. 1992; 86: 563-566
- Safety of spinal angiography: complication rate analysis in 302 diagnostic angiograms.Neurology. 2011; 77: 1235-1240
- Characteristics of spontaneous spinal cord infarction and proposed diagnostic criteria.JAMA Neurol. 2019; 76: 56-63
- Vertebral body infarction as a confirmatory sign of spinal cord ischemic stroke.Stroke. 1998; 29: 239-243
- MR imaging of spinal cord and vertebral body infarction.Am J Neuroradiol. 1992; 13: 145-154
- Atypical spinal cord infarction: a case report.Medicine (Baltimore). 2018; 97: 1-4
- Anterior spinal artery stroke demonstrated by echo-planar DWI.Eur Radiol. 2001; 11: 2607-2610
- Spinal cord infarction: MR imaging and clinical features in 16 cases.Neuroradiology. 2002; 44: 851-857
- Spinal cord infarction: prognosis and recovery in a series of 36 patients.Spinal Cord. 2001; 39: 520-525
- Spinal cord infarction: clinical and imaging insights from the periprocedural setting.J Neurol Sci. 2018; 388: 162-167
- Artery of Adamkiewicz: a meta-analysis of anatomical characteristics.Neuroradiology. 2019; ([Epub ahead of print])https://doi.org/10.1007/s00234-019-02207-y
Article info
Publication history
Published online: September 26, 2019
Accepted:
June 22,
2019
Received in revised form:
June 7,
2019
Received:
April 15,
2019
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.