Spinal Cord Infarction Mimicking Acute Transverse Myelitis

Spinal cord infarction (SCI) is a rare type of stroke. The initial magnetic resonance imaging (MRI) is usually normal and can mimic the presentation of the acute transverse myelitis (ATM), acute inflammatory demyelinating polyneuropathy, and compressive myelopathies from neoplasm, epidural or subdural hematoma, or abscess. The aim of this report is to describe and discuss the case of a patient with SCI presenting as a diagnostic confusion with acute transverse myelitis. A 64-year-old male with a medical history of hypertension presented with an acute onset of urinary retention with lower limb weakness. Based on the initial MRI and evaluation, a diagnosis of acute transverse myelitis was made. Despite thorough evaluation, the etiology of transverse myelitis was undetermined. Hence, the MRI of the thoracic spine was repeated which showed patchier enhancements of the vertebral body with features suggestive of the spinal cord and vertebral body infarction. Thus, a repeat MRI is required to make an accurate diagnosis. The vertebral body is always involved and can be of diagnostic significance as it reflects the pathology of underlying blood supply.