The challenge of diagnosing the acute nontraumatic tetraplegia of a healthy young woman. (1st June 2015)

• Record Type: Journal Article
• Authors: Genovese, Maurilio; Todeschini, Alessandra; Moratti, Claudio; Galassi, Giuliana
• Is Part Of: International journal of neuroscience. Volume 125:Number 4(2015:Apr.)
• Page Start: 307
• Page End: 311
• Publication Date: 2015-06-01
• Subjects: Nervous system -- Periodicals; 612.805
• DOI: 10.3109/00207454.2014.924124
• Languages: English
• ISSNs: 0020-7454

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <p>Acute nontraumatic myelopathies include vascular etiologies most commonly caused by atherosclerotic vascular disease. Other causes that have been reported to occur with varying frequencies include thrombosis, embolism of thrombi and tumor, arteritis, hypotension, dissecting aortic aneurysm, sickle cell disease, intervertebral disk herniation, vertebral body subluxation and iatrogenic causes, usually angiography or surgery. In case of acutely progressing spinal cord syndromes, the diagnosis often given is of transverse myelitis or unknown cause of infarction. Fibrocartilaginous embolism (FCE) is possible cause of spinal ischemia due to embolization of nucleus pulposus fragments through retrograde spinal artery flow. A young woman after intensive exercise developed profound weakness of her upper extremities, progressing to flaccid quadriplegia with sensory level from C3 dermatome. Magnetic resonance imaging (MRI) showed linear hyperintense intramedullary lesion from C2 to Th2 confined to anterior horn area, with typical"owl's eye" appearance. Although exact mechanism of patient's neurological syndrome remains undetermined, we suspected a cord infarction due to FCE related to her vigorous physical exercise.</p> </abstract>