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A 39-year-old man developed sudden vertigo,chest and bilateral arm pain, bilateral arm weakness,and wasting involving muscles innervated by the sixth cervical to the first thoracic spine cord segments.Magnetic resonance imaging showed an extensive right vertebral artery dissection and a right posterior inferior cerebellar infarct.Magnetic resonance scans showed a small focal hyperintensity in the region of each anterior horn, extending from the mid to lower cervical spine cord.Minimal recovery of function was present after 3 months.Unilateral vertebral artery dissection may give rise to disabling bilateral upper extremity amyotrophy.Watershed infarction within the anterior spinal artery territory,involving both anterior horns,appears to be the mechanism of the lower motor neuron injury. |
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anterior horn cell disease anterior spinal artery infarction arm weakness arterial dissection arterial dissection,vertebral motor neuron disease MRI MRI,abnormal MRI,spinal cord MRI,spinal cord,increased intramedullary cord signal muscle atrophy,static pain,arm spinal cord spinal cord,infarction of spinal cord,ischemic lesion of watershed infarcts
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