Sulcal artery syndrome presenting as an incomplete Brown–Sequard syndrome – Report of an unusual case and review of the literature

Abstract

Sulcal arteries perfuse the anterior two-thirds of the spinal cord, and spinal cord infarction as a result of sulcal artery occlusion is rare. Most reported cases are associated with vertebral artery dissection, and commonly involve the cervical spinal cord. A 74-year-old man presented with sudden onset weakness and numbness after a brief bout of abdominal pain. Further investigations concluded that this was sulcal artery syndrome. We report a case of sulcal artery syndrome affecting the thoracic spinal cord presenting as Brown–Sequard syndrome. Sulcal artery syndrome usually has good prognoses, unlike anterior spinal artery infarction.

A Curious Case of Progressive Respiratory Failure Due to Anterior Spinal Cord Infarction in an Adolescent Boy: A Case Report and Review of the Literature

“…To this category belongs the rare sulcocommissural syndrome, resulting from the occlusion of the sulcal artery and presenting as an incomplete Brown-Séquard's syndrome with sparing of the posterior third of the hemicord. 5 Diagnosis of SCI is challenging, even in the presence of an inciting event such as cardiovascular disease (hypotension and cardiac arrest), a blunt trauma (vascular dissection, vascular compression by hematoma, disk fragment, or bone), 6 meningitis (thrombosis), surgical intervention, 7 or medical procedure (intravascular catheterization and spinal block). Spontaneous spinal cord infarctions (SSCIs) are frequently misdiagnosed as idiopathic transverse myelitis.…”

“…To this category belongs the rare sulcocommissural syndrome, resulting from the occlusion of the sulcal artery and presenting as an incomplete Brown-Séquard's syndrome with sparing of the posterior third of the hemicord. 5…”