Background: Traumatic spinal cord infarction was initially described in the era previous to the availability of MRI. This entity occurs in children and affects the thoracic spinal cord, usually presenting as a delayed cord injury. Patients have a high incidence of associated blunt thoracic or retroperitoneal trauma and arterial hypotension at admission. The described mechanism of injury is a traumatic occlusion of the aortic branches nourishing the spinal cord. It shares several characteristics with SCIWORA. In past years, the presence of this injury has received little importance.
Case description: A 5-year-old boy suffered from high-energy blunt trauma over the thoracoabdominal area, presenting hypotension, retroperitoneal injury, and delayed complete thoracic SCI. An MRI showed spinal cord infarction located in the territory of AKA. During subsequent examinations, the boy did not show signs of neurological improvement.
Conclusion: It is important to include TSCIf in the diagnosis of children who present delayed SCI (hours to 4-5 days), especially if the injury is located in the thoracic cord and is accompanied by blunt thoracic or abdominal trauma. Because the conventional radiographic tests are normal, TSCIf can be considered as a special type of SCIWORA.