The Thoracic Spinal Cord Ischemia due to a Mural Thrombus of the Thoracic Aorta : A Case Report

We report an unusual case of spinal transient ischemic attack due to a mural thrombus in the thoracic aorta. A 62-year-old man suddenly developed a severe back pain, and noticed numbness and weakness of both lower extremities, which resolved within an hour. The patient was admitted to our institute due to the same attack. On admission, neurological examination revealed transverse myelopathy at the level of the 8th thoracic spinal cord. Although CT and MRI demonstrated no abnormal lesion in the spinal cord, a mural thrombus was detected in the thoracic aorta. We considered the mural thrombus occluded the radicular artery, resulting in spinal cord ischemia. He recovered fully with the conservative treatment, including platelet antiaggregant and thrombolytic therapy, and was discharged 18 days after the onset of symptoms. In a patient with rare spinal TIA, careful attention also should be paid to the possibility of an aortic lesion.