An Ischemic Infarct in Medulla and Cervical Cord

This report documents an unusual case of an occlusion of the anterior spinal artery of the medulla oblongata. The patient presented with involvement of the left accessory nerve and weakness of ipsilateral extremities. The diagnosis of an ischemic infarct in the distribution of the left proximal portion of the anterior spinal artery was made. Bulbar weakness, quadriplegia, and respiratory arrest developed. Postmortem examination, 23 days after onset, revealed an old infarct in the medulla which appeared as a more recent hemorrhagic infarct throughout the cervical cord