1123 - Spinal Cord Infarction Following Cardiac Arrest in a Young Adult: A Rare Complication of Global Hypoperfusion

Friday, February 20, 2026

5:00 PM - 6:30 PM AST

Presenting Author(s)

BK

Brandon Khanyan, MD

Medical Student
Stony Brook University Medical School
Great Neck, New York, United States

Co-Author(s)

MH

Myrna Hanna, DO

Resident Physician
Montefiore Medical Center
New Hyde Park, New York, United States
HC

Haris Choudry, MD

Program Director
Burke Rehabilitation Hospital
White Plains, New York, United States

Submitter(s)

BK

Brandon Khanyan, MD

Stony Brook University School of Medicine
Great Neck, New York, United States

Case Diagnosis: Spinal cord infarction is a rare neurological complication, accounting for only 1-2% of all strokes, and is exceedingly uncommon following cardiac arrest, estimated in fewer than 0.1% of cases. Most infarcts involve the anterior spinal artery and are seen in older adults with atherosclerosis or after aortic surgery. In contrast, this case involves mid-thoracic spinal cord infarction in a young adult resulting from global hypoperfusion due to prolonged resuscitation (44 minutes).

Case Description: A 20-year-old female presenting following cardiac arrest secondary to diabetic ketoacidosis, resulting in an anoxic brain injury, T6 spinal cord infarction, and right above-knee amputation from lower limb ischemia. Her hospital course was complicated by respiratory failure requiring tracheostomy, sepsis, renal failure requiring dialysis, and paraplegia. She presented with 0/5 bilateral lower extremity strength and absent sensation from T6. On admission to acute rehab, the patient required maximal assistance for mobility and transfers. She progressed to moderate assist with improved wheelchair skills.

Discussions: This case highlights a rare instance of concurrent anoxic brain injury and amputation resulting from a single acute event, illustrating the complexity of managing a young adult with spinal cord infarction after cardiac arrest. The presence of a right AKA and anoxic brain injury further complicated mobility training and prosthetic planning. These challenges were most evident in transfer techniques and impaired sitting balance, further complicated by cognitive and communication impairments from anoxic brain injury. Physiatrists are specially trained to address all three conditions and tailor rehab plans based on the strengths and limitations of each injury. This case emphasizes the importance of personalized rehabilitation approaches and raises awareness of spinal cord infarction as a potential complication in post-cardiac arrest care.

Conclusions: Spinal cord infarction, though rare after cardiac arrest, becomes especially complex when paired with brain injury and ischemic limb loss, requiring rehab plans beyond traditional SCI approaches.