Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

A case of conus medullaris infarction expanding to the vertebral bodies, major psoas and erector spinae muscles

Takuya Konno, M.D., Ph.D.1), Tatsuya Suwabe, M.D.1), Sou Kasahara, M.D.1), Yoshitaka Umeda, M.D.1), Mutsuo Oyake, M.D., Ph.D.1) and Nobuya Fujita, M.D., Ph.D.1)

1)Department of Neurology, Nagaoka Red Cross Hospital

A 77-year-old woman presented with conus medullaris and cauda equina syndrome following a sudden pain in the bilateral lower abdomen and right buttock. Lumbar magnetic resonance imaging (MRI) showed not only a conus medullaris lesion, but also several lesions in the vertebral bodies (L1, L2), right major psoas muscle, right multifidus muscle and bilateral erector spinae muscles. As these areas receive blood supply from each branch of the same segmental artery, we considered all of the lesions as infarctions that were a result of a single parent vessel occlusion. It is known that a vertebral body lesion can be accompanied by a spinal cord infarction, but in combination with infarction of a muscle has not been reported. This is the first report of a concomitant spinal cord and muscle infarction revealed by MRI. It is noteworthy that a spinal cord infarction could expand not only to neighboring vertebral bodies, but also to muscles.
Full Text of this Article in Japanese PDF (493K)

(CLINICA NEUROL, 55: 661|664, 2015)
key words: conus medullaris syndrome, spinal cord infarction, vertebral body infarction, muscle infarction, steroid pulse therapy

(Received: 26-Feb-15)