Abstract
We report a case of spinal cord infarction with acute onset of right scapular pain radiating to the sternum. Serial magnetic resonance imaging (MRI) revealed an abnormal signal intensity in the cord at the levels corresponding to the neurologic deficits in the patient, whereas CT-myelography failed to demonstrate any abnormalities. Ten days after admission, the T2-weighted images (T2WI) demonstrated an abnormally increased signal in the anterior aspect of the cord at the same level. Gadolinium-DTPA enhanced T1WI revealed cord enhancement at a level of Th1/2 intervetebral disc and Th2 vertebral body. One hundred and twenty-eight days following admission, T1WI revealed decreased signal in the anterior aspect of the cord from the Th1 to the Th2 vertebral bodies. The T2WI showed reduction of the increased signal intensity area compared with the T2WI taken on the 10th admission day. Axial T1WI showed decreased signal in the anterior portion of the cord at the level of Th1/2 intervertebral disc and Th2 thoracic spine. In consideration of the neurologic examination and MRI findings in this case, the patients was diagnosed with a spinal cord infarction of Th4.
