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Case report
peer-reviewed

Spinal Cord Infarction Mimicking Acute Transverse Myelitis



Abstract

Spinal cord infarction (SCI) is a rare type of stroke. The initial magnetic resonance imaging (MRI) is usually normal and can mimic the presentation of the acute transverse myelitis (ATM), acute inflammatory demyelinating polyneuropathy, and compressive myelopathies from neoplasm, epidural or subdural hematoma, or abscess. The aim of this report is to describe and discuss the case of a patient with SCI presenting as a diagnostic confusion with acute transverse myelitis. A 64-year-old male with a medical history of hypertension presented with an acute onset of urinary retention with lower limb weakness. Based on the initial MRI and evaluation, a diagnosis of acute transverse myelitis was made. Despite thorough evaluation, the etiology of transverse myelitis was undetermined. Hence, the MRI of the thoracic spine was repeated which showed patchier enhancements of the vertebral body with features suggestive of the spinal cord and vertebral body infarction. Thus, a repeat MRI is required to make an accurate diagnosis. The vertebral body is always involved and can be of diagnostic significance as it reflects the pathology of underlying blood supply.



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Case report
peer-reviewed

Spinal Cord Infarction Mimicking Acute Transverse Myelitis


Author Information

Nilesh H. Pawar Corresponding Author

Department of General Medicine, Sengkang General Hospital, Sengkang Health, Singhealth, Singapore

Ealing Loke

Department of General Medicine, Sengkang General Hospital, Sengkang Health, Singhealth

Derrick C. Aw

Department of General Medicine, Sengkang General Hospital, Sengkang Health, Singhealth


Ethics Statement and Conflict of Interest Disclosures

Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.


Case report
peer-reviewed

Spinal Cord Infarction Mimicking Acute Transverse Myelitis


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Case report
peer-reviewed

Spinal Cord Infarction Mimicking Acute Transverse Myelitis

Nilesh H. Pawar">Nilesh H. Pawar , Ealing Loke">Ealing Loke, Derrick C. Aw">Derrick C. Aw

  • Author Information
    Nilesh H. Pawar Corresponding Author

    Department of General Medicine, Sengkang General Hospital, Sengkang Health, Singhealth, Singapore

    Ealing Loke

    Department of General Medicine, Sengkang General Hospital, Sengkang Health, Singhealth

    Derrick C. Aw

    Department of General Medicine, Sengkang General Hospital, Sengkang Health, Singhealth


    Ethics Statement and Conflict of Interest Disclosures

    Human subjects: Consent was obtained by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

    Acknowledgements


    Article Information

    Published: December 06, 2017

    DOI

    10.7759/cureus.1911

    Cite this article as:

    Pawar N H, Loke E, Aw D C (December 06, 2017) Spinal Cord Infarction Mimicking Acute Transverse Myelitis. Cureus 9(12): e1911. doi:10.7759/cureus.1911

    Publication history

    Received by Cureus: November 12, 2017
    Peer review began: November 22, 2017
    Peer review concluded: December 03, 2017
    Published: December 06, 2017

    Copyright

    © Copyright 2017
    Pawar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 3.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

    License

    This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Spinal cord infarction (SCI) is a rare type of stroke. The initial magnetic resonance imaging (MRI) is usually normal and can mimic the presentation of the acute transverse myelitis (ATM), acute inflammatory demyelinating polyneuropathy, and compressive myelopathies from neoplasm, epidural or subdural hematoma, or abscess. The aim of this report is to describe and discuss the case of a patient with SCI presenting as a diagnostic confusion with acute transverse myelitis. A 64-year-old male with a medical history of hypertension presented with an acute onset of urinary retention with lower limb weakness. Based on the initial MRI and evaluation, a diagnosis of acute transverse myelitis was made. Despite thorough evaluation, the etiology of transverse myelitis was undetermined. Hence, the MRI of the thoracic spine was repeated which showed patchier enhancements of the vertebral body with features suggestive of the spinal cord and vertebral body infarction. Thus, a repeat MRI is required to make an accurate diagnosis. The vertebral body is always involved and can be of diagnostic significance as it reflects the pathology of underlying blood supply.



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Create a free account to continue reading this article.

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Nilesh H. Pawar, M.D.

Department of General Medicine, Sengkang General Hospital, Sengkang Health, Singhealth, Singapore

For correspondence:
pawarnh@gmail.com

Ealing Loke

Department of General Medicine, Sengkang General Hospital, Sengkang Health, Singhealth

Derrick C. Aw

Department of General Medicine, Sengkang General Hospital, Sengkang Health, Singhealth

Nilesh H. Pawar, M.D.

Department of General Medicine, Sengkang General Hospital, Sengkang Health, Singhealth, Singapore

For correspondence:
pawarnh@gmail.com

Ealing Loke

Department of General Medicine, Sengkang General Hospital, Sengkang Health, Singhealth

Derrick C. Aw

Department of General Medicine, Sengkang General Hospital, Sengkang Health, Singhealth