Spectrum of clinicoradiological findings in spinal cord infarction: Report of three cases and review of the literature
A 62-year-old gentleman with a background of hypertension and cervical spondylosis presented with acute onset of quadriparesis. The weakness was preceded by sudden onset of giddiness, following which he had a fall with transient loss of consciousness lasting a few seconds. Quadriparesis evolved within 2 h and bladder distention was subsequently noted. On examination, the sensorium was preserved. Tone was decreased in all four limbs, power was grade 2 in the upper limbs and grade 3 in the lower limbs. Sensory examination was normal. MRI of the cervical spine [] showed features of cervical spondylosis with ossified posterolateral ligament predominantly at the C3-C4 levels causing cord indentation with signal changes. No brainstem infarcts were noted. MR angiogram of the cerebral vessels, neck vessel Doppler, ECG and echocardiogram were normal.\nPossibility of an ischemic insult to the cord related to FCE in the setting of a cervical spondylotic myelopathy was considered. The patient was started on supportive therapy, antiplatelets and steroids. The lower limbs improved to grade 4 power and the upper limb power marginally improved to grade 3. Repeat MRI at 3 weeks [Figure and ] showed focal high-signal T2 W and STIR hyperintensity at the C3 level, which was consistent with infarction.