Teaching NeuroImages: Spinal cord infarct due to fibrocartilaginous embolism in an adolescent

Abstract

A 15-year-old healthy, active girl presented with acute bilateral upper extremity tingling and hand weakness while playing golf; within several hours, she developed numbness and weakness in all limbs. She denied preceding trauma and bowel/bladder incontinence. Examination showed global weakness, normal tone and reflexes, a C5 sensory level, and decreased light touch/temperature/pinprick in all limbs. Neuroimaging revealed an anterior spinal artery cervical cord infarct (figure), along with a degenerative disk, attributed to fibrocartilaginous embolism.