Acute anterior spinal cord syndrome following cardiac arrest during coronary angiography

Open Access

Abstract

Spinal cord infarction is an uncommon neurological emergency and accounts for approximately 1-2% of all vascular neurological disorders. Anterior spinal cord syndrome (ASCS) is the commonest clinical presentation and is characterised by acute motor weakness and dissociated sensory loss with preservation of posterior column functions. I report the case of a 70-year-old man who developed acute spastic paraparesis with loss of pain and crude touch sensation up to the xiphisternum following recovery from a cardiac arrest that occurred during coronary angiography. Neurological examination revealed spastic paraparesis, bilateral extensor plantar responses, a sensory level at approximately T6, preservation of vibration and joint position senses and urinary retention requiring catheterisation. The clinical findings were highly suggestive of anterior spinal cord syndrome secondary to spinal cord ischaemia resulting from global hypoperfusion during cardiac arrest. This case highlights the importance of recognising spinal cord ischaemia in patients presenting with acute myelopathy following cardiac arrest or invasive cardiac procedures.