Thoracic Spinal Cord Infarct Presenting as Monoplegia

Spinal cord infarction, a rare but severe condition, accounts for a small percentage of ischemic strokes and acute myelopathies. This case describes a 58-year-old Hispanic man with a history of hypertension, diabetes, hyperlipidemia, and cocaine use who presented with sudden onset of right-sided lower-limb monoplegia. Imaging revealed T2 hyperintensity in the anterior cord from T3 to T6, consistent with acute or subacute infarction. Despite extensive evaluation, no thrombus or significant arterial abnormalities were identified. The infarction was attributed to cocaine-induced vasospasm, underscoring the importance of considering drug-induced causes in atypical presentations of spinal cord injury and the relevance of vascular anatomy.