Sulcal artery syndrome

Last revised by Yuranga Weerakkody on 1 Jun 2019

Sulcal artery syndrome is a rare cause of spinal cord infarction involving the territory of one of the sulcal arteries, which are penetrating branches of the anterior spinal artery, each vessel supplying either left or right side of the cord, but not both. The result is an incomplete Brown-Séquard syndrome sparing the dorsal columns. 

Patients present with an acute incomplete Brown-Séquard syndrome involving the cervical cord, and consisting of: 

  • ipsilateral arm and leg weakness
  • contralateral sensory loss to temperature or hyperalgesia 
  • minimal or no loss of vibratory sensation and proprioception as the posterior columns are not involved (these are supplied by the posterior spinal arteries)

MRI is the modality of choice for assessing patients with suspected cord infarction. 

The key finding is that of a region of T2 increased signal, confined to a relatively short segment of one side of the cord. Often there is a short linear extension of the increased signal into the contralateral cord along the crossing anterior spinal commissure 2

In many instances, the prognosis of sulcal artery syndrome is good with significant improvement present even at short-term follow-up. Often there is only minimal or no long-term neurological deficits.

ADVERTISEMENT: Supporters see fewer/no ads

Cases and figures

  • Figure 1
    Drag here to reorder.