Presumed fibrocartilaginous embolism causing spinal cord infarct in 8-year-old female: A case report

Fibrocartilaginous embolism (FCE) is a rare, underrecognized cause of spinal cord infarction (SCI) resulting from embolic migration of nucleus pulposus material into the spinal vasculature. It is characterized by acute myelopathy, often following minor trauma or exertion, with diagnosis often challenging due to its rarity and nonspecific features. We report the case of an 8-year-old previously healthy girl who presented with spontaneous hyperacute quadriparesis, back pain, and bowel and bladder dysfunction. MRI revealed longitudinally extensive T2-weighted hyperintensity extending from C5-T8, predominantly involving the ventral cord, with corresponding diffusion restriction and a C6-C7 disc protrusion. Following empiric steroids and plasmapheresis, she demonstrated progressive, near-complete neurological recovery. This case highlights a rare pediatric presentation of FCE-associated SCI without an identifiable inciting event. Although prognosis is often poor, early recognition of suggestive clinical and radiologic features (particularly longitudinal ventral cord involvement with the “owl’s eye” sign and associated discovertebral pathology) and timely supportive therapy may result in substantial functional recovery.