Supplementary Material for: Exertion-Induced Spinal Cord Infarction in a Middle-Aged Man: A Case Report

Introduction: Spinal cord infarction (SCI) is a relatively rare disorder, constituting 1-2% of ischemic strokes and 5-8% of all acute myelopathies.
Case Presentation: Here we describe a case of SCI in a 49-year-old male with no prior neurological history that presented to the Emergency Department of Virginia Commonwealth University with sudden onset bilateral lower extremity paralysis, decreased sensation, and urinary retention after weightlifting. Spinal Magnetic Resonance Imaging (MRI) revealed anterior signal abnormality T8 down to conus medullaris, terminating at L1 compatible with SCI. T9-T10 moderate spinal stenosis, along with degenerative changes L5-S1 were seen. Abdominal CT angiography revealed no signs of aortic dissection and no evidence of intestinal ischemia. He was treated with gabapentin for neuropathic abdominal pain and aspirin.
Conclusion: This case represents an uncommon presentation of exertion induced SCI. In patients with acute neurologic symptoms with absence of trauma, SCI should remain high on the differential.