[P3-162] Spinal cord infarction caused by handstand in an 11-year-old girl: report of a case
Spinal cord infarction in children is an extremely rare life-threatening disorder. It occurs suddenly after the minor trauma in most cases, therefore; the adequate treatment might be delayed. We present an 11-year-old girl with spinal cord infarction. She was admitted to our hospital for sever buttock pain after handstand. At 1 hour after admission, she exhibited flaccid paralysis of her legs, hyperesthesia in her bottom and abdomen, bladder-rectal disturbance, complete sensory loss below Th11, and absent deep tendon reflex of her legs. Spinal MRI at 24 hours after admission showed the swollen spinal cord with T2-elogation around gray matter at the T10-12 levels. The steroid pulse therapy, anticoagulant therapy and limitation in flexion successfully improved buttock pain, but motor and sensory loss remained. At 40 days after admission, she was transferred to rehabilitation facility. The pathological mechanism by which the minor trauma causes spinal cord infarction is recognized as embolism of fibrocartilages vasospasm or dissection of spinal artery. The involvement of anterior and posterior the lower thoracic cord suggested that the infarction was caused by fibrocartilagenous embolism or disruption of Adamkiewicz artery. In this case, the early intervention with complete rest, and steroid pulse therapy might have improved spasm of upper extremities and prevented progressive infarct and edema of the spinal cord.