- Author:
Dae Won LEE
1
;
Yoon Hee CHOI
Author Information
- Publication Type:Case Report
- Keywords: Spinal cord ischemia; Chest pain; Back pain
- MeSH: Back Pain; Chest Pain; Emergencies; Heart Diseases; Humans; Hypesthesia; Infarction*; Knee; Leg; Lower Extremity; Magnetic Resonance Imaging; Myocardial Infarction; Myocardial Ischemia*; Neurologic Manifestations; Physical Examination; Reflex, Stretch; Sensation; Spinal Cord Ischemia; Spinal Cord*
- From: Clinical and Experimental Emergency Medicine 2017;4(2):109-112
- CountryRepublic of Korea
- Language:English
- Abstract: Spinal cord infarction is a rare condition and is easily misdiagnosed owing to its initial non-specific manifestation. We report a case of a 77–year-old man who presented with chest pain and upper back pain initially, and was misdiagnosed with a myocardial infarction. Four hours after admission, he complained of numbness in his entire left leg below the knee, with rapid deterioration of neurological symptoms. After 9 hours, loss of sensation progressed up to the T4 dermatome, strength of both lower extremities deteriorated to grade 0, and decrease in anal tone and deep tendon reflex was observed. Initial magnetic resonance imaging findings were normal; however, a signal change occurred 3 days after symptom onset. When patients present with acute chest pain and neurologic symptoms, the possibility of ischemic cardiac disease as well as any neurological manifestations must be investigated. Emergency physicians must remember the value of serial physical examinations.