[A case of conus syndrome following arteriogenic impotence]

A patient with conus syndrome following arteriogenic impotence is described. A 62-year-old man became impotent. 7 months after the onset, he was admitted because of a sudden left sensorimotor disturbance (L2 to S5 segments) when he awoke. A marked bilateral reduction of cutaneous sensation in the S2 to S5 dermatome distribution persisted. An MRI of the spinal cord demonstrated no abnormal lesion on T2-weighted and Gadolinium enhanced images. Angiography of the pelvic artery showed severe arteriosclerotic findings. We diagnosed this case as a conus syndrome due to ischemia in the conus medullaris. The impotence in our case was considered to be arteriogenic because there was no detection of the bilateral deep arteries of the penis on angiography after an intracorporeal PGE1 injection. In this case, arteriogenic impotence might be a prodrome of a conus medullaris infarction.