title: Thoracic disc herniation presenting with transient anterior spinal artery syndrome. A case report.
abstract: This report is a clinical and radiologic correlation of anterior spinal arterial distribution ischemia with a thoracic disc herniation affecting the artery of Adamkiewicz. We could only find one other similar reported case. A 38-year-old woman developed sudden onset of severe back pain and radiculopathy, followed by rapidly evolving paraparesis. The neurological examination was consistent with a deficit caused by anterior spinal artery ischemia. MRI revealed T2 signal change in the thoracolumbar spinal cord and a laterally placed, non-calcified disc herniation. Selective spinal angiography performed 30 hours after onset revealed displacement of the left T9 radicular feeding artery by the disc herniation; at this time the artery was patent. The patient experienced some resolution of symptoms within the first 24 hours and was managed conservatively and made a significant recovery within two weeks. Appropriately located thoracic disc herniations can disturb the blood supply to the thoracolumbar spinal cord.
authors.affiliation: Department of Neurological Surgery and Miami Project to Cure Paralysis, University of Miami; Miami, FL, USA - tmarotta@vanhosp.bc.ca.
authors.forename: J D
authors.initials: JD
authors.lastname: Guest
authors.forename: D E
authors.initials: DE
authors.lastname: Griesdale
authors.forename: T
authors.initials: T
authors.lastname: Marotta