title: Spectrum of clinicoradiological findings in spinal cord infarction: Report of three cases and review of the literature.
abstract: Spinal cord infarction (SCI) often remains undiagnosed due to infrequent occurrence and lack of established diagnostic procedures. The unique pattern of blood supply explains the heterogeneity of clinical presentation. We present three cases of SCI to highlight the varied spectrum of clinicoradiological findings. The first patient had posterior spinal artery infarction, and spine imaging showed infarction of adjacent vertebral body, which is usually rare. The second patient had anterior spinal artery infarction and the cANCA titers were elevated. The third patient had a pure motor quadriparesis. Initial imaging did not show any cord infarction, but signal changes were noted on serial imaging. Fibrocartilagenous embolism (FCE) seems the most likely etiology in the first and third cases. A high index of clinical suspicion is necessary for prompt diagnosis. Sensitivity of the initial magnetic resonance imaging remains limited, necessitating serial follow-up scans. Infarction of the adjacent vertebral body is a useful confirmatory sign. Fat suppression images can delineate the marrow signal changes better. Elderly patients with vascular risk factors and degenerative discs need to avoid mechanical triggers that predispose to FCE. Younger patients with SCI will need evaluation for cardioembolic source and vasculitis.
authors: Department of Neurological Sciences, Christian Medical College, Vellore, India.
authors: Ajith
authors: A
authors: Sivadasan
authors: Mathew
authors: M
authors: Alexander
authors: Anil K
authors: AK
authors: Patil
authors: Sunithi
authors: S
authors: Mani
keywords: Anterior spinal artery; fibrocartilagenous embolism; magnetic resonance imaging; posterior spinal artery; spinal cord infarction
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