Acute Spinal Cord Infarct Secondary to Fibrocartilaginous Embolism Treated With Tenecteplase.
Jenica Patel, Prasuna Kamireddi, Sneha Jacob
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Case in brief
A 56-year-old male with hypertension experienced sudden left arm and leg weakness following a Valsalva maneuver. Examination revealed dense flaccid paralysis. MRI indicated a spinal infarct, and after ruling out other causes, fibrocartilaginous embolism was diagnosed. The patient received thrombolytic therapy and high-dose steroids, resulting in mild improvement. At one-year follow-up, he was able to walk without support and showed some motor recovery.
What made this case unusual
The case illustrates fibrocartilaginous embolism as a rare cause of spinal cord infarction, particularly in a middle-aged patient, which is not commonly reported.
Diagnostic / clinical pearl
Clinicians should consider fibrocartilaginous embolism in the differential diagnosis of acute myelopathy, especially in patients with a history of physical exertion.
Why it matters
This case underscores the need for awareness of atypical causes of spinal cord infarction and the potential role of thrombolytic therapy, which requires further study.