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Abstract Details

Anterior Spinal Cord Infarction Following Spontaneous Vertebral Artery Dissection
Cerebrovascular Disease and Interventional Neurology
Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)
223
N/A
Cervical artery dissections occur when a false lumen forms and blood is shunted into the vessel wall. This can lead to thromboembolism or hypoperfusion leading to ischemia and subsequent stroke. Spontaneous artery dissection is reported to occur in 0.97 per 100,000, with the mean age of diagnosis of 44-46.
N/a
78-year-old male with history of hypertension, hyperlipidemia, and type 2 diabetes mellitus presented with acute onset shooting neck pain and left sided hemiparesis. The patient was found to have a left hemiparesis with arm weaker than leg and significant paresthesias and neuropathic pain. An MRI c-spine and brain were completed which initially demonstrated a T2 hyper intensity at the level of C3 to C5 concerning for transverse myelitis. Given the patients age and risk factors, a repeated MRI c-spine was completed with DWI and ADC sequences which demonstrated an acute infarction involving the left hemicord at the level of C3 to C5. A CTA head and neck was also completed which demonstrated a vertebral artery dissection from its origin to C4. There was no vascular anomalies, risk factors, or trauma associated with the vertebral dissection. The patient was evaluated and worked with physical therapy with improvement in his weakness, but continued to have proximal greater than distal weakness of his left upper extremity.
This case illustrates a unique result of a spontaneous vertebral artery dissection leading to a left hemicord infarction. Even with his cervical artery dissection, often the focus is on brain imaging, which may miss spinal cord infarct, potentially delaying treatment and diagnosis.
Authors/Disclosures
Joshua Luster, MD
PRESENTER 		Dr. Luster has nothing to disclose.
Brent Jacobus II, MD Dr. Jacobus has nothing to disclose.