Abstract
A 58-year-old man presented to the emergency department complaining of acute onset of interscapular and left shoulder pain, with associated left lower extremity weakness. Vital signs included a blood pressure of 240/112 mm Hg. Physical examination revealed complete paresis of the left lower extremity, moderate weakness of the left hand and forearm, and decreased pinprick sensation on the right extending to the C8/T1 level. Peripheral vascular and cardiopulmonary examination results were normal. Ancillary study results were unremarkable. Computed tomography revealed no evidence of thoracic aortic dissection. Magnetic resonance imaging (MRI) of the cervical and thoracic spine was obtained (Figure).
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