A case of benign postpartum anterior spinal artery syndrome with thrombocytosis and high fibrolytic activity

: A 35-year-old woman was admitted to our hospital with acute onset paraparesis, sensory disturbance in her lower body, and urinary disturbance. She had given birth by normal vaginal delivery 6 days before the onset of these symptoms. On admission, paresis of her left leg was more severe than that of her right leg. Deep tendon reflexes of her lower limbs were hyperactive, and bilateral Babinski reflexes were observed. The patient's thermal and pain sensations below the lumbus were impaired. She lost bladder-filling sensation and bladder control. She showed an anterior spinal artery syndrome. Blood analysis revealed thrombocytosis and high fibrolytic activity. MRI of the brain and spinal cord did not show any lesions. Cerebrospinal fluid measurements showed that parameters were within the normal range and that the protein levels were not increased. We considered that a spinal cord infarction had occurred. After administration of antithrombotic agents and methylpredonisolone, her symptoms gradually improved. The coagulation disorders during the peripartum period were assumed to be a cause of anterior spinal artery syndrome in this case. It is very rare for perinatal women to have a spinal cord infarction. Only 3 cases of spinal cord infarction during the perinatal period have been reported thus far.