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Abstract Details

A rare presentation of perinatal spinal cord infarct
Child Neurology and Developmental Neurology
P12 - Poster Session 12 (12:00 PM-1:00 PM)
5-006
To present a rare case of perinatal spinal cord infarct.

Perinatal stroke is a common pathology affecting between 1/2300 to 1/5000 newborns.  It is defined as an acute neurologic issue that occurs between the 20th week of gestation and 28 days postnatally.  While common, the challenge of diagnosis of a perinatal stroke lies in the fact that stroke in the neonate presents with signs and symptoms of seizure, often delaying the diagnosis.  Furthermore, spinal cord infarct is extremely rare, accounting for approximately 1% of all strokes.
N/A
A woman presented at 40 weeks gestation due to decreased fetal movement. The baby was delivered via C-section and was noted to be apneic, floppy, and cyanotic. APGAR scores were 2, 7, and 8 at 1, 5, and 10 minutes, respectively.  On exam, the baby displayed generalized hypotonia, greater in the upper extremities and was moving both lower limbs and left arm, with brisk reflexes in the lower limbs. Spinal MRI showed edema in the cervical cord at C2-C3 to C7-T1 that was concerning for possible tumor, and the baby was referred to a cancer center. MRI cervical cord was repeated and demonstrated resolution of the previous cervical cord enhancement. There was focal hyperintense T2 signal in the right lateral cord at C3 level and left lateral cord at C4 level and possible myelomalacia. These findings were most consistent with spinal cord infarct. Over the subsequent 6 months, the patient received physical therapy and regained near-normal strength in his legs but continued to have hypotonia, decreased DTRs, and weakness in the arms. Repeat imaging at 6 months demonstrated evolution of myelomalacia but no new lesions.
This case is an unusual presentation of perinatal spinal cord infarct, which is rarer than perinatal cerebral infarct but should be considered in neonates with quadriparesis.
Authors/Disclosures
Gilad Muth, DO (Albany Medical Center)
PRESENTER 		Dr. Muth has nothing to disclose.
Devorah Segal, MD, PhD (NYU Langone) Dr. Segal has nothing to disclose.