Infarction of the conus medullaris--clinical and radiographic features

A 53-year-old woman experienced an acute onset of flaccid weakness of the legs associated with severe abdominal and lower limb pain. Sensory loss extended from L3 to S5. Constipation, recurrent abdominal pain and urinary retention were problems during the course of her illness. Six months after the onset the patient could walk with assistance. A myelogram and CT scan of the lower dorsal and lumbar spine showed no abnormality. Magnetic resonance imaging confirmed the diagnosis of infarct of the conus medullaris. This case highlights the clinical features of spontaneous infarction of the conus medullaris and emphasises the value of magnetic resonance scanning for the diagnosis of lesions of the spinal cord.