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Spinal Cord Infarction from an Unstable Aortic Plaque

Published online by Cambridge University Press:  02 December 2014

Jamsheed A. Desai  and
Nicola Gambarotta
Jamsheed A. Desai*
Affiliation:
Department of Medicine, Queen's University, Kingston, Ontario, Canada
Nicola Gambarotta
Affiliation:
Department of Radiology, Queen's University, Kingston, Ontario, Canada
*
Queen's University, Department of Medicine (Neurology), c/o Connell 7, Kingston General Hospital, 76 Stuart Street, Kingston, Ontario, K7L 2V7, Canada
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A 78 year-old woman presented with acute onset low back pain with radiation into the right T12-L2 dermatomes, progressive flaccid paraparesis, urinary incontinence and bilateral lower extremity paresthesias. Examination revealed flaccid paraparesis, and a T12 sensory level to pin with intact vibration and proprioception. Magnetic resonance imaging (MRI) (Figure 1) of the spinal cord demonstrated T2 hyperintensity and restricted diffusion from T12 to the conus medullaris. Computed tomogram (CT) aortogram (Figure 2) highlighted an ulcerated plaque and thrombus at the approximate level of the artery of Adamkiewicz. These findings were consistent with a spinal cord infarct of the cord from T12-L2. The patient was treated with Clopidogrel and IV heparin (x two days) and was transferred for spinal cord rehabilitation.

Type
Neuroimaging Highlights
Information
Canadian Journal of Neurological Sciences , Volume 38 , Issue 1 , January 2011 , pp. 145 - 146
Copyright
Copyright © Canadian Neurological Sciences Federation 2011

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