Antetior spinal artery infarction

New very interesting case Req opinion from Radiologist, Neurology, Neurosurgeon & all others.Once in a while only one can see cases like this. 52 yr F,DM, Developed parasthesia of abrupt onset chest & adjacent back while doing laundry.She stopped the work took some rest ,became better.The next day morning developed numbness below the umbilicus. She did some household work & continued the remaining previous day laundry. She didnot have any weakness of the limbs.After lunch she went to bed & got up after an hr when she realised that both her legs are weak& UNABLE TO GET UP.Evaluated at local hospital , introduced Folys catheter & then referred. Exam all peripheral pulsations intact. Normal cranial nerves & upper limbs. Gr0/5 power both lower limbs wth absent DTRs & "0" plantars .Absent pain & temperature below D4 b/ l. No spinal deformity / tenderness/ bruit

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Congratulations! Your case has been selected as Case of the day and you have been awarded 5 points for sharing the case. Keep posting your interesting cases, Happy Curofying!

Thank Curofy & all others who answered.Thanks DrKrishnendu for the first correct answer.It is a case of spinal infarction .I put as an interesting case since it is a spinal infarction , all of us are very familiar with stroke affecting the intracranial vascular structures. Currently pt is on clopidogrel with active physio. Motor power is gr 2 / 5.All vasculitis screening -ve.MRI repoUt is posting

Anterior spinal artery occlusion, -> long segment asa infarct

Thanks Dr krishnendu fo the quick answer
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Deseminated myelitis

Transverse myelitis.

Long segment cord Signal intensity changes noted predominantly on T2& evident on FLAIR With restricted diffusion. Features are consistent with Dorsolumbar cord. Infarction.

Post compression involving first post coloum ten ant ....do daminoplasty and decompression of cord

Anterior spinal artery occlusion with infarct DWI restriction present and ADC low

Anterior cord infarction is there. What is coagulation profile. Start antiplatelets. Steroids may help.

Better to rule out tranverse myelites including demyelinating diseases

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