title: Posterior spinal artery syndrome showing marked swelling of the spinal cord: a clinico-pathological study.
abstract: OBJECTIVE
  To describe a rare autopsy case of posterior spinal artery syndrome with marked swelling of the spinal cord, an unusually subacute onset and short clinical course.
  
  
  METHODS
  Case report.
  
  
  RESULTS
  An 84-year-old Japanese woman  presented with bilateral muscle weakness of the lower legs and sensory disturbance 1 week after head contusion. Neurological findings worsened gradually. She developed phrenic nerve paralysis and died of respiratory failure 6 weeks after the onset of neurological symptoms. On pathological  examination, the spinal cord was markedly swollen in the cervical and upper thoracic segments. Microscopically, there was loss of myelin sheath in the bilateral posterior columns and neuronal loss of the posterior horns in all of the spinal segments. However, findings were unremarkable in  the bilateral anterior columns and bilateral anterior horns in most of the spinal segments. Posterior spinal arteries had no stenosis, occlusion, or thrombosis. We considered that pathogenesis was infarction associated with head injury.
  
  
  CONCLUSIONS
  To our knowledge, this  is the first report of a case of posterior spinal artery syndrome with a markedly swollen spinal cord and poor prognosis.
authors: Tokyo Medical University, Shinjuku-ku, Tokyo, Japan. jun-ma@tokyo-med.ac.jp
authors: Jun
authors: J
authors: Matsubayashi
authors: Kuniaki
authors: K
authors: Tsuchiya
authors: Soichiro
authors: S
authors: Shimizu
authors: Naoyuki
authors: N
authors: Kitagawa
authors: Yukari
authors: Y
authors: Wakabayashi
authors: Masahiko
authors: M
authors: Kuroda
authors: Michio
authors: M
authors: Sakurai
authors: Toshitaka
authors: T
authors: Nagao
mesh_terms: D000058:Accidental Falls; D000369:Aged, 80 and over; D017809:Fatal Outcome; D005260:Female; D016489:Head Injuries, Closed / Q000150:complications*; D006801:Humans; D008279:Magnetic Resonance Imaging; D013116:Spinal Cord / Q000098:blood supply / Q000473:pathology; D020758:Spinal Cord Vascular Diseases / Q000209:etiology* / Q000473:pathology*