Acute spinal cord ischemia syndrome

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Acute paraplegia 2 days following aortic surgery.

Patient Data

Age: 70 years
Gender: Male

Swelling of the spinal cord from T10 level up to the conus medullarus of high T2 and STIR signal involving mainly the central portion of the cord with restricted diffusion on DWI / ADC.

Case Discussion

The clinical presentation and MRI features in a patient with a recent history of aortic surgery are most consistent with an acute spinal cord ischemia syndrome.

MRI is the gold standard imaging in patients with suspected spinal cord ischemia. It is used to:

  • to confirm the diagnosis

  • and to exclude other more readily treated causes of cord impairment (e.g. compression)

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