A Case of Spinal Stroke Due to the Obstruction of Adamkiewicz Artery

ABSTRACT

BACKGROUND: Spinal stroke is unusual, accounting for 1% of all cases of stroke in general hospital. The clinical features of anterior spinal artery syndromes due to Adamkiewicz artery obstruction are dissociative sensory disturbances, motor weakness, and autonomic dysfunctions. There have been several reports of using magnetic resonance imaging(MRI) in ischemic spinal cord infarctions. However, angiographic and MRI finding of the obstruction of Adamkiewicz artery has never been reported in Korea. CASE A previously healthy 60-year-old woman presented an acute onset of paralysis of both lower limbs. On admission she showed paralysis and anesthesia of both lower limbs, and loss of bladder function. Routine hematological and CSF studies revealed no abnormalities. MRI disclosed T11-L2 level spinal cord infarction on T1- and T2-weighted images. Posterior tibial somatosensory evoked potential study revealed prolongation of cortical waves. Spinal angiographic findings were compatible with spinal cord infarction due to the obstruction of Adamkiewicz artery. COMMENT: To our knowledge, this is believed to be the first case of spinal stroke due to the obstruction of Adamkiewicz artery confirmed both by MRI and by angiography in Korean literature.