Abstract
Acute spinal cord ischemia secondary to hypovolemic shock related to acute myocardial Infarction
Highlights
Acute spinal cord infarction (SCI) is a rare condition, accounting for 1% of stroke [1] and represents a diagnostic challenge
SCI can lead to paralysis or paraparesis and carries a high rate of mortality: recognizing SCI early is crucial so that the causes producing ischemia can be corrected to limit infarction
We describe a patient who developed permanent paraplegia following hypovolemic shock related to acute myocardial infarction
Summary
Acute spinal cord infarction (SCI) is a rare condition, accounting for 1% of stroke [1] and represents a diagnostic challenge. Two days later (postoperative day 4) she complained of being unable to move her legs and was found to be paraplegic (flaccid paraplegia and areflexia without pyramidal signs) with urinary retention, hypotonic anal sphincter and a T7 sensory level with preserved propioception and vibration sensation. These findings were most consistent with acute SCI affecting the anterior spinal cord. MRI (Diffusion-weighted image, DWI) of the thoracic spine showing anterior hyperintensity in mid-thoracic cord (arrow). The MI was successfully treated with resuscitation, stenting This case shows that a patient with MI can develop SCI without concomitant cerebral infarction. A profound and sustained arterial hypotension may cause SCI, involving primarily the watershed area of the cord, between T1 and T4 cord segments [10]
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