Anterior spinal artery syndrome: A case report

Nontraumatic spinal cord ischemia is uncommon, especially at the cervical spinal cord. We describe a 30-year-old man presenting with acute onset of quadriparesis and impaired sensation for pain and temperature after backing up the car. He was diagnosed noninvasively with magnetic resonance imaging (MRI) and electrophysiological studies. The image studies had revealed a high signal intensity lesion in the cord from C5 to the upper part of thoracic spinal cord (T2) on T2-weighted images. The nerve conduction velocity study (NCV) revealed non pick-up of bilateral F waves and median nerves of upper limbs with decreased compound muscle action potentials (CMAPs) of the bilateral ulnar nerves. Motor evoked potentials (MEP) after transcranial cortical stimulation revealed low amplitudes and abnormal central conduction time to the legs and arms, which was more severe on the upper limbs and especially on the left side. The patient regained most of the muscle power except extensor muscles of the elbow and wrist after conservative treatment.