Preservation of evoked potentials in a case of anterior spinal artery syndrome

A case of anterior spinal artery syndrome is presented for which there are neurologic, electrophysiologic, and pathologic correlations. Ten days prior to her death, a 52-year-old hypertensive female developed severe chest pain and lower extremity weakness. A diagnosis of aortic dissection resulting in an anterior spinal artery syndrome was made. Intraoperative posterior tibial somatosensory evoked potentials demonstrated normal morphology and latencies. Autopsy revealed an infarction of the anterior portion of the thoraco-lumbar spinal cord with preservation of the posterior columns. This case demonstrates that severe spinal cord injury can exist in the presence of preserved somatosensory evoked potentials.