[A case of spinal cord infarction caused by cervical disc herniation]

A 40-year-old previously healthy female was diagnosed with acute progressive paraparesis. Neurological examination revealed bilateral four-limb weakness predominant in the distal part of the upper limbs and superficial sensory impairment below the cervical region. T2-weighted image on MRI showed an area of hyperintensity in the gray matter of the cervical cord with disc herniation at the C4/C5 vertebral level. Laboratory investigation showed no evidence of infections, autoimmune, inflammatory, or neoplastic causes. A follow-up MRI study 3 days after admission showed that the region of hyperintensity was had enlarged without contrast enhancement. Spinal angiography was performed 21 days after admission and demonstrated that the anterior spinal artery originated from the fourth segment of the left vertebral artery and occluded at the level of C4/C5, which coincided with the location of disc herniation. We hypothesized that she developed anterior spinal artery syndrome which caused disc herniation. Although we frequently encountered disc herniation, there are few cases developed spinal cord infarction. We discuss the etiology and pathogenetic relation between disc herniation and spinal cord infarction.