Rare presentation of acute anterior cord syndrome due to fibrocartilaginous embolism in a pediatric patient following minor trauma.

Abstract

Background: Anterior spinal cord syndrome (ASCS) is an extremely rare condition defined as an infarction of the anterior two-thirds of the spinal cord. The type and timing of the clinical presentation, combined with the radiological findings, can provide a focused clinical picture of the severity and outcomes and direct the management plan. We present a rare case report of a pediatric patient with ASCS in acute settings due to a fibrocartilaginous embolism (FCE).

Case description: We report a 10-year-old girl who was medically and surgically free. She presented with ASCS features 30 min after lifting her younger sister in her back. The clinical presentation consisted of bilateral lower limbs weakness 0/5 according to the medical research council's scale, weak anal tone, with pain and temperature significantly altered and absent up to T4 level. A diagnosis of anterior spinal infarction due to FCE was made after excluding the possible anterior cord syndrome etiologies. The management consisted of aspirin and extensive physiotherapy, and she significantly recovered over 1 month.

Conclusion: We report a rare case of acute presentation of a pediatric patient with ASCS due to FCE. The timing of a diagnosis affects clinical results. Correlating the radiological findings to the clinical presentation can narrow the differential diagnosis. The literature on the management of these cases is lacking. Animal studies reported a trial of medical therapy.