SHM Converge Scientific Abstract ePoster Gallery-A Rare Presentation of Artery of Adamkiewicz Occlusion in a 64-Year-Old Male

Pdf Summary

This poster describes a rare case of anterior spinal cord syndrome caused by occlusion of the artery of Adamkiewicz in a 64-year-old man with no known thrombophilia history. He presented with rapidly progressive bilateral ascending leg weakness and numbness, later involving the upper extremities, along with shortness of breath. Examination showed areflexia and decreased strength and sensation, especially in the lower extremities.<br /><br />Initial thoracic spine MRI showed an abnormal intramedullary lesion from C6 to T5, raising concern for infarct versus inflammation. Because the presentation also suggested Guillain-Barré syndrome, the patient was treated with high-dose IV steroids and then IVIG. However, he did not improve. Lumbar puncture, infectious testing, and a broad hypercoagulable/autoimmune workup were largely negative, though inflammatory markers were elevated.<br /><br />Repeat MRI suggested evolving spinal cord swelling or a mass-like lesion. A spinal angiogram was then performed and demonstrated non-visualization of the artery of Adamkiewicz, supporting spinal cord ischemia due to arterial occlusion. The underlying cause of the occlusion was not identified, but the authors suspected a possible hypercoagulable state. After starting apixaban (Eliquis), the patient showed significant improvement in lower extremity weakness and paresthesias.<br /><br />The poster emphasizes that anterior spinal artery syndrome is rare and can present with nonspecific symptoms that mimic more common neurologic disorders such as GBS or MS. Clinicians should maintain a high index of suspicion and pursue further vascular evaluation, including spinal angiography, when standard workup is unrevealing.

Asset Subtitle

Aaron Sidhu

Meta Tag

Author List Aaron Sidhu, Harneet Grewal

Category Clinical Vignettes

Concept Artery of Adamkiewicz

Concept Anterior Spinal Artery

Concept Anterior Spinal Artery Syndrome

Concept Spinal Cord Infarction

Concept Spinal Cord Blood Supply

Distinguished Non-Finalist

Presenter Organization Abrazo Health

Presenting Author Aaron Sidhu

Track Adult

Keywords

anterior spinal cord syndrome

artery of Adamkiewicz

spinal cord ischemia

spinal angiography

bilateral leg weakness

ascending numbness

Guillain-Barré syndrome

intramedullary lesion

hypercoagulable state

apixaban

Artery of Adamkiewicz

Anterior Spinal Artery

Anterior Spinal Artery Syndrome

Spinal Cord Infarction

Spinal Cord Blood Supply