Spinal Cord Infarction Presenting as Right-Sided Upper Back Pain: A Case Report
Filipa Madalena F Gonçalves1, Ana Luísa Campos1, Magda Costa1
1Internal Medicine, Hospital Senhora Oliveira, Guimarães, PRT.
Cureus
|November 16, 2022
Summary
Spinal cord infarction is a rare neurological event. This case highlights a biphasic presentation and challenges in diagnosing and managing this condition due to limited clinical data.
Area of Science:
- Neurology
- Vascular Neurology
- Neurosurgery
Background:
- Spinal cord infarction is an uncommon cause of neurological deficits.
- Prompt diagnosis and management are crucial for patient outcomes.
Observation:
- A 39-year-old man presented with atypical chest pain, initially non-diagnostic.
- Neurologic deficits emerged on day two, revealing a medullary infarction (C5-T2) via CT scan.
- The patient experienced quadriplegia (Asia Impairment Scale D) with left-sided predominance and hand grip deficits.
Findings:
- The infarction was deemed idiopathic after extensive etiological investigation.
- Dual antiplatelet therapy was initiated for treatment.
- The patient required extensive rehabilitation for bladder and motor retraining.
Implications:
- This case underscores the diagnostic challenges posed by atypical presentations of spinal cord infarction.
- The biphasic nature of the ictus complicates early recognition and intervention.
- Limited clinical data necessitates further research into the optimal management strategies for spinal cord infarction.
Keywords:
chest painemergency departmentischemic cerebrovascular diseasemedullary infarctmedullary strokespinal cord infarction
