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AJNR - American Journal of Neuroradiology

Published ahead of print on April 15, 2009
doi: 10.3174/ajnr.A1567

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American Journal of Neuroradiology 30:1691-1693, October 2009
© 2009 American Society of Neuroradiology

Case Report
SPINE

A Case of Spinal Cord Infarction Following Lumbar Transforaminal Epidural Steroid Injection: MR Imaging and Angiographic Findings

E.M. Lyders^a and P.P. Morris^a

^aFrom the Division of Radiological Sciences, Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC.

Please address correspondence to P. Pearse Morris, MB, Bch, Division of Radiological Sciences, Department of Radiology, 2nd Floor Meads Hall, Wake Forest University School of Medicine, Winston-Salem, NC 27157; email: pmorris{at}wfubmc.edu

SUMMARY: Spinal cord infarction following lumbar transforaminal epidural steroid injection is a rare and devastating complication. We describe the case of a 55-year-old woman who developed spinal cord infarction following right L2-3 transforaminal epidural injection, diagnosed on the basis of clinical and MR imaging findings. Spinal angiography demonstrated occlusion of the right L2 segmental artery with reconstitution of the radicular branch from collaterals. The artery of Adamkeiwicz could not be demonstrated and was presumably occluded by the steroid injection.