Context: We describe a case of unilateral posterior upper cervical spinal cord infarction and propose a pathophysiologic mechanism causing this lesion after vertebral artery endovascular intervention.
Findings: A 70-year-old male presented with subacute onset of left hemibody sensory changes and gait instability following a left vertebral angioplasty procedure. MRI cervical spine revealed upper posterior cervical spinal cord infarction (PSCI). After 3 months patient had substantial improvement of his symptoms.
Conclusion: PSCI is rare but can present as a complication from vertebral artery angioplasty procedure. Early diagnosis of PSCI can be achieved with adequate understanding of its clinical signs and the blood supply of the spinal cord.