1120 - Spinal infarction and Anterior Cord Syndrome secondary to the Heimlich Maneuver: A Case Report

Thursday, February 19, 2026

5:00 PM - 6:30 PM AST

Presenting Author(s)

AO

Ashley Otto, DO

Resident Physician
Thomas Jefferson University Hospital - Department of PM&R
philadelphia, Pennsylvania, United States
CS

Charles Siegel, MD

Resident physician
Thomas Jefferson University Hospital and Magee Rehabilitation
Philadelphia, Pennsylvania, United States
AK

Adrian Kase, MD

Resident Physician
Thomas Jefferson University Hospital
Philadelphia, Pennsylvania, United States

Co-Author(s)

KG

Kristin Gustafson, DO

Director of Spinal Cord Injury and Disorders Medicine
Thomas Jefferson University Hospital, Sydney Kimmel Medical College, Jefferson University
philadelphia, Pennsylvania, United States
DL

David Leong, DO

Clinical Assistant Professor
Jefferson Moss-Magee Rehabilitation Hospital- Center City
Philadelphia, Pennsylvania, United States

Submitter(s)

AO

Ashley Otto, DO

Thomas Jefferson University Hospital - Department of PM&R
philadelphia, Pennsylvania, United States

Case Diagnosis: Traumatic incomplete paraplegia secondary to SDH/SAH and associated acute spinal cord infarction via Heimlich maneuver

Case Description: A 64-year-old woman presented after twelve hours of bilateral lower extremity weakness and sensory changes after receiving the Heimlich maneuver. Physical exam was notable for 0/4 tone and flaccid reflexes in lower extremities, 0/5 manual muscle testing (MMT) in lower extremity key muscles, impaired light touch (LT) sensation, and loss of pinprick (PP) sensation from T8 distally. Cumulatively, patient’s initial ASIA exam was a T8 AIS B. MRI T/L spine imaging was significant for C7-T1 anterior epidural collection, multiple small hemangiomas through the thoracic spine, and abnormal T2 hypodense signal throughout the entire thecal sac of the thoracic spine with mass effect on spinal cord. Spinal angiogram ( Right T6, T8-L3, Left T7-L1) was unable to locate the source of the bleed. Repeat MRI T spine showed circumferential T1 to iso-hyperintense subdural/subarachnoid hemorrhage throughout the spinal canal extending from C3 to the termination of the thecal sac in the sacrum.

Discussions: Spinal cord infarction and hemorrhagic myelopathy are rare but devastating causes of spinal cord injury. Common causes of spinal cord injury include due cord compression from edema, mass effect, bleeding, or bony changes. This can result from trauma, infections, tumors, degenerative conditions, and vascular disorders. While these are known precipitations of spinal infarction, we present a novel case of thoracic spinal cord infarction secondary to traumatic Heimlich maneuver, subsequent hemorrhage and resultant paraplegia . This unique presentation expands our understanding of spinal vascular injury and its potential mechanisms.

Conclusions: This is a novel case of traumatic paraplegia secondary to the heimlich maneuver which presents an opportunity to better understand spinal vascular injury and its potential mechanisms.