Anterior spinal artery syndrome in a girl with Down syndrome: case report and literature review.
OBJECTIVE
Anterior spinal artery syndrome is an extremely rare cause of acute ischemic cord infarction in children. It is caused by hypoperfusion of the anterior spinal artery, leading to ischemia in the anterior two thirds of the spinal cord. The presentation is usually with an acute and painful myelopathy with impaired bladder and bowel control. Pain and temperature sensation below the lesion are lost, whereas vibration and position sense is intact because of the preservation of the posterior columns.


METHODS
Case report.


RESULTS
A 16-year-old girl with Down syndrome presented with urinary retention and acute complete flaccid paralysis of the legs with absent deep tendon and abdominal reflexes. Magnetic resonance imaging showed a signal abnormality in the anterior half of the thoracic cord from T5 to T12, consistent with anterior spinal artery infarction.


CONCLUSIONS
Pediatricians should consider anterior spinal artery syndrome in the child who presents with acute, painful myelopathy. We summarize the etiology, neurological findings and outcomes of 19 children found in the literature with anterior spinal artery syndrome.
Sohal
Aman Singh
AS
Department of Paediatric Neurology, Royal Liverpool Children's Hospital, Liverpool, United Kingdom. manusohal@rediffmail.com
Sundaram
Manu
M
Mallewa
Mac
M
Tawil
Mohamed
M
Kneen
Rachel
R
D000293:Adolescent; D020759:Anterior Spinal Artery Syndrome / Q000150:complications* / Q000473:pathology; D004314:Down Syndrome / Q000150:complications* / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods