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Atypical presentation of spinal cord infarction after a pulseless electrical activity arrest

BMJ 2016; 353 doi: https://doi.org/10.1136/bmj.i2936 (Published 31 May 2016) Cite this as: BMJ 2016;353:i2936
  1. Laura Hayes, foundation year 2 doctor, acute medicine1,
  2. Rainu Bawa, foundation year doctor, acute medicine1,
  3. Jan Coebergh, consultant neurologist1
  1. 1ASPH, St Peter's Hospital, Chertsey KT16 0PZ, UK
  1. lkhayes{at}doctors.org.uk

A 43 year old woman had a pulseless electrical activity arrest. Spontaneous circulation returned after cardiopulmonary resuscitation was performed for 10 minutes. Subsequent examination showed bilateral, lower limb flaccid paralysis. No sensory deficit was present. Magnetic resonance imaging confirmed central thoracic cord hyperintensity between levels T8 and T12 (fig 1). Most cases of spinal cord infarction (SCI) are idiopathic or vascular in nature. About 3.6% are caused by hypotension, and a handful of cases cite cardiac arrest as the root cause. This case highlights post-arrest SCI caused by systemic hypotension. Patients with clinical signs of peripheral neurological deficit should undergo imaging to aid diagnosis.

Footnotes

  • Patient consent obtained.

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