A knowledge of the normal anatomy and anatomic relationships of the carotid and vertebral arteries, as well as the biomechanics by which traumatic injury occurs to these vessels, is important both in the interpretation of diagnostic arteriograms and in the clinical assessment of the injured patient.
Anterior spinal artery (ASA) infarction is a rare but well-described cause of flaccid paraparesis in adults, presenting with a high thoracic spinothalamic sensory level and preservation of dorsal column function. Careful sensory examination, demonstrating loss of spinothalamic modalities with preservation of dorsal column modalities, supports a clinical diagnosis of ASA infarction. Findings on conventional MRI of the spinal cord are often non-specific, and diffusion-weighted imaging (DWI) is not routinely performed. We describe four children with ASA infarction after minor trauma. DWI was performed in all cases and confirmed the clinical diagnosis.
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