Vertebral body infarction as a confirmatory sign of anterior spinal artery syndrome – a case report

Introduction: The anterior spinal artery syndrome describes a rare anterior spinal cord syndrome which is mostly caused by ischemia. An assocation with vertebral body infarction(s) on MRI is rarely described in the literature and only in adults.

Case report: Patients history: a 14-year old boy, suddenly felt, after a football game, – without any trauma -, radicular (“girdle“) pain rapidly followed by paraparesis and paresthesia below the level T3/T4; Clinical signs : flaccid, followed by spastic paraparesis; below the level T3/T4: loss of pain and temperature, preservation of proprioception and vibration sensation; impaired bladder control. Diagnostic findings: the MRI showed homogenously reduced diffusion in the whole vertebral body T4 and a hyperintense signal in T2-weighted sagittal images; on the same level of the myelon, there was central an intramedullary hyperintense signal in T2-weighted images. With the MRT follow-up on the one side and the neurologic signs on the other side, a vertebral body infarction as confirmatory sign of ischemic anterior spinal artery syndrome could be diagnosed. In adolescents an infarction of the spinal cord can result after a relatively minor trauma to this area.

Conclusion: A vertebral body infarction in anterior spinal artery syndrome is in the literature not described in an adolescent. The follow-up will show the neurological outcome and the MRI changes of the vertebral body infarction.

Keywords: anterior spinal artery syndrome, vertebral body infarction, magnet resonance imaging