Spinal cord infarction due to a self-inflicted needle stick injury

Case report.

To report a case of spinal cord infarction after a self-inflicted needle stick injury, following an injection of heroin into the cord.

National spinal injury unit in a Scottish University teaching hospital, Glasgow, UK.

A 20-year-old male, injected street heroin accidentally into the cord through the left side of the neck, leading to sudden loss of power to all four limbs. Initial magnetic resonance imaging scans showed extensive cord oedema and follow-up scans showed signal changes within the anterior horns of the spinal cord in keeping with a cord infarct.

Self-inflicted spinal cord injury with a small needle is difficult, but not impossible. Cord infarct as a result of a self-inflicted injury has not been previously reported. The mechanism of the injury resulting in cord infarction is explained by the vascular anatomy of the spinal cord circulation, and this may also explain the residual neurological status of the patient.