Spinal cord infarction is an uncommon but important problem. Often it is a diagnosis of exclusion, having ruled out other causes of acute spinal symptoms such as multiple sclerosis, transverse myelitis, disc herniation, spinal canal stenosis, contusion, congestive myelopathy secondary to dural arteriovenous fistula and spinal tumours. In this article we discuss the important arterial anatomy of the spinal cord and use it to make sense of a case of spinal cord infarction.
A 39-year-old woman was admitted with sudden onset of pain in the back and legs, accompanied by spasm and numbness, whilst in bed at night. On examination she had bilaterally spastic legs with profound ankle weakness, particularly on the right. Ankle reflexes were absent, while her plantar reflexes were mute. There was loss of pin-prick sensation in the S2/3 dermatomes, with loss of anal tone and reflexes. MRI examination on the day of admission
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