A Case of Posterior Spinal Artery Infarction after Cervical Trauma

ABSTRACT

Clinically, the infarction of posterior spinal arteries is rarely recognized due to rich anastomosis. As a result, there have been few clinical reports of posterior spinal artery infarction. A 38-year-old man experienced severe transitory neck and occipital pain after his friend had struck him on the cervical area. A few days later, he developed dysmetria, dysdiadochokinesia, and decreased vibration and position senses on the right side of his body. Routine laboratory find-ings, an echocardiogram, a work-up for connective tissue diseases, and CSF studies were all found to be normal. A MRI showed increased signals in the right posterior and posterolateral part of the lower medulla and some portion of the first cervical cord on T2- and proton-weighted images without significant enhancements. A cerebral angiogram showed a long narrow thread-like segment in the distal portion of the right vertebral artery, which was indicative of a dissection. The right posterior inferior cerebellar artery was not visualized.