Spinal Cord Infarction Presenting as Right-Sided Upper Back Pain: A Case Report

Spinal cord infarction is a very rare event with a wide variety of symptoms at presentation. We describe the case of a 39-year-old man who presented to the emergency department with atypical chest pain. The initial investigations were non-diagnostic, and the patient was admitted for surveillance. On the second day of admission, he developed neurologic deficits; a second computed tomography showed a medullary infarction at levels C5-T2. Dual antiplatelet therapy was initiated. An extensive study on the underlying etiology was performed. It was considered to be an idiopathic event. The patient was discharged to a rehabilitation center for bladder training and motor training due to quadriplegia level D on Asia Impairment Scale with a C6 neurological level with left predominance and a hand grip deficit that disabled him to grab objects. This case report describes a rare event with a biphasic ictus at presentation. It highlights the difficulty in managing this pathology because of limited clinical data.