Neurology: anterior spinal artery syndrome: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Neurology: anterior spinal artery syndrome

Sample item

After thoracoabdominal aortic aneurysm repair, a man develops sudden bilateral flaccid paralysis of the legs with loss of pain and temperature sensation below T8 and urinary retention. Vibration and joint position sense are preserved. What is the diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Anterior spinal artery infarction

Anterior spinal artery occlusion infarcts the anterior two-thirds of the cord, damaging the corticospinal and spinothalamic tracts and anterior horns, while the dorsal columns, supplied by the posterior spinal arteries, are spared. It is a recognised complication of aortic surgery.

Option by option

  • A. Subacute combined degeneration

    Subacute combined degeneration is gradual and affects the dorsal columns and corticospinal tracts.

  • B. Anterior spinal artery infarction (correct)

    Correct. Loss of motor function and pain-temperature sensation with preserved dorsal column modalities localises to the anterior cord.

  • C. Brown-Sequard syndrome

    Brown-Sequard syndrome causes ipsilateral weakness and loss of proprioception with contralateral loss of pain and temperature.

  • D. Posterior spinal artery infarction

    Posterior spinal artery infarction affects the dorsal columns and spares motor power.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Anterior spinal artery infarction. Anterior spinal artery occlusion infarcts the anterior two-thirds of the cord, damaging the corticospinal and spinothalamic tracts and anterior horns, while the dorsal columns, supplied by the posterior spinal arteries, are spared.

Why is "Subacute combined degeneration" not the answer?

Subacute combined degeneration is gradual and affects the dorsal columns and corticospinal tracts.

Why is "Brown-Sequard syndrome" not the answer?

Brown-Sequard syndrome causes ipsilateral weakness and loss of proprioception with contralateral loss of pain and temperature.

Why is "Posterior spinal artery infarction" not the answer?

Posterior spinal artery infarction affects the dorsal columns and spares motor power.

What concept does this question test?

It tests Neurology: anterior spinal artery syndrome in General Medicine. It is a recognised complication of aortic surgery.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neurology: anterior spinal artery syndrome?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.