Clinical Communications: Adult| Volume 57, ISSUE 4, P560-562, October 2019

Acute Spinal Cord Infarction Presenting With Chest Pain and Neurogenic Shock: A Case Report

  • Angie Wu
    Department of Emergency Medicine, MedStar Health, Columbia, Maryland
    Search for articles by this author
  • Jonathan E. Davis
    Reprint Address: Jonathan E. Davis, md, MedStar Health & Georgetown University, Ground Floor, CCC Building, 3800 Reservoir Road, NW, Washington, DC 20007
    Department of Emergency Medicine, MedStar Health, Columbia, Maryland

    Georgetown University School of Medicine, Washington, District of Columbia
    Search for articles by this author
Published:September 26, 2019DOI:



      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.


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