CASE REPORT   

Chirurgia 2019 August;32(4):191-6

DOI: 10.23736/S0394-9508.18.04813-1

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Subacute progressive ascending myelopathy following motor vehicle accident

Abdulrahman Y. QATOMAH ¹ ✉, Ahmed ALHABTER ², Asma ALQAHTANI ³, Ali ALBSHABSHI ⁴, Ibrahim ALNAAMI ⁴

¹ Department of Internal Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia; ² Physical and Rehabilitation Center, King Fahad Medical City, Riyadh, Saudi Arabia; ³ College of Medicine, King Khalid University, Abha, Saudi Arabia; ⁴ Department of Surgery, College of Medicine, King Khalid University, Abha, Saudi Arabia

This is the case report of a patient with sub-acute progressive ascending myelopathy (SPAM) after a motor vehicle accident. The aim of this paper is to draw attention to the course and outcome with regard to neurological findings following the initial insult, and to discuss evidence supporting an underlying vascular etiology. A 21-year-old man developed clinical and MRI evidence of ascending myelopathy, extending up to cervical 6, 1 days after a T11/12 left sided fracture dislocation. The distribution of MRI signal abnormality, and a possibility of spinal cord infarction with a lesion involving the territory of supplementary ascending cervical artery was implemented. Following recent spinal cord injury, the possibility of spinal cord infarction evident by MRI finding would contribute to the etiology of SPAM. With an obliteration of spinal cord perfusion, a subsequent development of myelopathy was observed. Given the rarity of this condition, it is unlikely that there will be treatment guidelines in the foreseeable future. Conducting prospective or even case control studies might not be feasible. Nevertheless, it might be worthwhile that we, as a spinal cord clinical community, continue reporting such cases. Ultimately, we might be able to come up with anecdotal recommendations of diagnosis and treatment.

KEY WORDS: Spinal cord diseases - Spinal cord ischemia - Bone barrow diseases