Teaching Neuro Images : Acute neurologic deficits due to surfer's myelopathy

Abstract

A previously healthy 32-year-old man developed acute onset of lower extremity weakness (American Spinal Injury Association [ASIA]-motor L2-S1, grade 2/5), T8 sensory level, and loss of bowel and bladder control (ASIA Impairment Scale [AIS] C) while surfing. The patient was a novice surfer and recalled a prolonged period in prone hyperextension. MRI spine was consistent with surfer's myelopathy, a rare nontraumatic cause of myelopathy found in novice surfers (figure).1,2 The etiology is postulated to be due to dynamic compression of the artery of Adamkiewicz. The patient recovered full function with conservative management over 3 days. Full recovery is expected in patients with AIS B or better, as opposed to patients with AIS A, who typically do not recover. 1 AUTHOR CONTRIBUTIONSJoshua Bakhsheshian: drafting/revising the manuscript for content, including medical writing for content, study concept or design, analysis or interpretation of data. Ki-Eun Chang: acquisition of data, analysis or interpretation of data. Ben A. Strickland: acquisition of data, analysis or interpretation of data. Dan A. Donoho: acquisition of data, analysis or