This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Faig, J. Articles by Salbeck, R. Search for Related Content PubMed PubMed Citation Articles by Faig, J. Articles by Salbeck, R.

(Stroke. 1998;29:239-243.)
© 1998 American Heart Association, Inc.

Case Reports

Vertebral Body Infarction as a Confirmatory Sign of Spinal Cord Ischemic Stroke

Report of Three Cases and Review of the Literature

Jochen Faig, MD; Otto Busse, MD; Rainer Salbeck, MD

From the Departments of Neurology (J.F., O.B.) and Radiology (R.S.), Klinikum Minden (Germany).

Correspondence to Dr med Jochen Faig, Neurologische Abteilung, Weserbergland-Klinik, Gruene Muehle 90, D-37671 Hoexter, Germany.

Abstract

Background —Acute spontaneous spinal cord syndromes often remain etiologically ambiguous despite extensive diagnostic efforts. In the previous literature five cases are described with acute spinal cord syndromes interpreted as spinal cord ischemic strokes because of association with vertebral body infarctions on MRI.

Case Descriptions—Three cases are presented, and the literature is reviewed. In addition to an extensive diagnostic battery including an initial MRI without pathological signs, follow-up MRI at different time intervals from the onset of symptoms showed T2 hyperintense signals in vertebral bodies. Patient 1, who had plaques in the abdominal aorta, had suffered a thoracolumbar spinal infarction; this and a concomitant infarction of the left portion of T-12 could be demonstrated on follow-up MRI on day 12. Patient 2, who had incomplete transverse spinal artery syndrome below T-3, had an abnormal signal at the T-2 level of the spinal cord on follow-up MRI on day 5; this was one segment above infarction of the dorsal area of T-3, corresponding to the ascending course of the medullary artery. The spinal cord of patient 3, who had a posterior spinal artery syndrome below T-11, was unremarkable on follow-up MRI on day 14, but a T2 hyperintense signal was noted in the dorsal area of T-10.

Conclusions—Vertebral body infarction represents the only confirmatory sign for the otherwise exclusionary diagnostic procedure for spinal cord ischemic stroke and must be searched for on follow-up MRI as a key to correct diagnosis.

Key Words: magnetic resonance imaging • spinal cord stroke • vertebral body infarction

This article has been cited by other articles:

				R. Dolan, G. Houston, and J. O'Riordan Brown-Sequard syndrome due to noncompressive disc prolapse and spinal cord infarction QJM, March 1, 2009; 102(3): 225 - 227. [Full Text] [PDF]

				J. Novy, A. Carruzzo, P. Maeder, and J. Bogousslavsky Spinal Cord Ischemia: Clinical and Imaging Patterns, Pathogenesis, and Outcomes in 27 Patients. Arch Neurol, August 1, 2006; 63(8): 1113 - 1120. [Abstract] [Full Text] [PDF]

				G. Amoiridis, I. Ameridou, and M. Mavridis Intervertebral disk and vertebral body infarction as a confirmatory sign of spinal cord ischemia Neurology, November 9, 2004; 63(9): 1755 - 1755. [Full Text] [PDF]