P.095 Holey Spinal Cord - A case of spinal cord stroke secondary to fibrocartilaginous embolism

Abstract

Background: Fibrocartilaginous embolism (FCE) is a rare reported cause of spinal cord infarction and likely underdiagnosed due to clinical unfamiliarity. FCE can present after a mild trauma and is characterized by back or neck pain along and a rapidly progressive myelopathy. We present a case of FCE and discuss how this clinical entity can break the typical rules of stroke. Methods: Case presentation Results: An otherwise healthy, 56-year-old professional sports coach presented a couple day history of progressive leg paresthesias and mild back pain, followed by unsteady gait and then inability to void. The left leg demonstrated mild weakness, hyperreflexivity, ataxia and an upgoing plantar response. The right leg became spastic and he then developed bilateral impairment of vibration and proprioception at the toes. An initial limited MRI lumbar spine was negative. A repeat MRI spine showed mild diffusion restriction of T10-11 and T11-12 and evidence of a bone infarct L2. He was diagnosed with a spinal cord infarct secondary to FCE. Conclusions: FCE should be considered in the differential for acute myelopathy. It can present with a progressive nature like transverse myelitis and MRI may be non-diagnostic. As more cases are being reported, FCE is becoming better defined and recognized.