Acute Spinal Cord Infarction Presenting With Chest Pain and Neurogenic Shock: A Case Report

J Emerg Med. 2019 Oct;57(4):560-562. doi: 10.1016/j.jemermed.2019.06.038. Epub 2019 Sep 26.

Abstract

Background: Spinal cord infarction (SCI) is rare, accounting for approximately 1% of strokes.

Case report: We present the case of a 63-year-old male who presented to the emergency department (ED) with chest pain and acute-onset generalized weakness and was ultimately diagnosed with SCI secondary to suspected occlusion of the artery of Adamkiewicz. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: SCI may present diagnostic challenges, with its predilection for mimicking other major emergency conditions, such as acute aortic dissection, aortic aneurysm rupture, spinal cord compressive myelopathy, or transverse myelitis. Its consequences are often significantly disabling initially, though patients may experience subsequent clinical improvement. It is important to include SCI in the differential for patients with chest or back pain coupled with neurologic symptoms.

Keywords: Adamkiewicz; chest pain; infarction; neurogenic shock; spinal cord; stroke.

Publication types

  • Case Reports

MeSH terms

  • Bone Neoplasms / complications*
  • Bone Neoplasms / etiology
  • Chest Pain / etiology
  • Emergency Service, Hospital / organization & administration
  • Humans
  • Infarction / etiology*
  • Infarction / physiopathology
  • Male
  • Middle Aged
  • Prostatic Neoplasms / complications
  • Spinal Cord / abnormalities*
  • Tomography, X-Ray Computed / methods