Vertebral body infarction indicating midthoracic spinal stroke

Study design: Case report. Objective: To illustrate the significance of vertebral body infarction as the only confirmatory sign of spinal cord ischemic stroke. Setting: Department of Neurology, St. Josef-Hospital, Bochum, Germany. Case description: A 65-year-old man presented with clinical features suggesting spontaneous spinal cord infarction in the territory of the left sulcocommissural artery at the level of Th 8. Sequential magnetic resonance imaging (MRI) investigations failed to demonstrate infarction of the spinal cord but T2-weighted images revealed bone marrow hyperintensities of vertebra Th 9 and 10 in their left and dorsal parts consistent with vertebral body infarction. Conclusion: In clinically presumed spontaneous spinal cord infarction and unremarkable signaling of the spinal cord during sequential MRI investigations vertebral body infarction may serve as the only confirmatory sign of spinal cord ischemic stroke.