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Neurological rarities
Fibrocartilaginous embolism: an under-recognised cause of young spinal stroke
  1. Sai Adithya Nagaratnam1,
  2. Raymond Lam Kwong Lee2,
  3. Jonathan Sturm1,3
  1. 1 Department of Neurology, Gosford Hospital, Gosford, New South Wales, Australia
  2. 2 Department of Radiology, Gosford Hospital, Gosford, New South Wales, Australia
  3. 3 University of Newcastle, Newcastle, New South Wales, Australia
  1. Correspondence to Dr Sai Adithya Nagaratnam, Department of Neurology, Gosford Hospital, Gosford, New South Wales, Australia; sai{at}nagaratnam.net

Abstract

Fibrocartilaginous embolism is a rarely reported cause of spinal cord infarction. Seemingly innocuous activities may be associated with nucleus pulposus material embolising to the spinal cord vasculature. We describe a 36-year-old woman presenting with bilateral arm paraesthesia and chest pain that evolved into an acute cord syndrome. Initial MR scan of spine showed central spinal cord T2-weighted hyperintensity over several vertebral levels, suggesting transverse myelitis. Repeat MR scan after her symptoms persisted showed an acute cord infarction from a presumed fibrocartilaginous embolus. Clinicians should consider fibrocartilaginous embolism in patients presenting with an acute cord syndrome with supportive radiological findings.

  • CEREBROVASCULAR DISEASE
  • CLINICAL NEUROLOGY
  • MRI

Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study.

https://doi.org/10.1136/practneurol-2021-003322

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    Data availability statement

    Data sharing not applicable as no datasets generated and/or analysed for this study.

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    Footnotes

    • Contributors All authors contributed to the conception, drafting of the manuscript and approve the final copy.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed by Aaron Berkowitz, California, USA.

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    • Editors’ commentary
      Highlights from this issue
      Phil E M Smith Geraint N Fuller
      Practical Neurology 2022; 22 261-261 Published Online First: 18 Jul 2022. doi: 10.1136/practneurol-2022-003520