Objective: To investigate the clinical and imaging characteristics of transverse spinal cord infarction (SCI) induced by aortic atherosclerosis combined with aneurysm, so as to improve the understanding of the disease in clinical practice.

Methods: One case of transverse SCI induced by aortic atherosclerosis combined with aneurysm and its clinical diagnosis and treatment process were reported. Neurological and imaging specialists were invited to discuss the clinical manifestations and imaging features of the disease based on the relevant literature review. 

Results: The clinical manifestations of a case of transverse SCI induced by aortic atherosclerosis combined with aneurysm were repeated numbness and weakness of the lower extremities with progressive aggravation. Magnetic resonance imaging (MRI) revealed an abnormal signal and slight swelling of the lower thoracic and lumbar spinal cord. Computed tomography angiography (CTA) showed dilated outer wall of the aortic arch, aortic atherosclerosis of aorta, and multiple ulcers in the inner wall of the aortic arch with mural thrombus; atherosclerotic plaques at both sides of the carotid bifurcation and the origin of the internal carotid artery with the stenosis of vascular cavity; dissecting changes in left common iliac artery, and localized mural thrombus in left internal iliac artery with obvious stenosis of vascular cavity. After definitive diagnosis, this case was transferred to interventional surgery for aortic aneurysm.

Conclusion: The incidence rate of SCI is much lower than that of cerebral infarction. Aortic disease is one of the common causes of SCI. Acute onset and rapid progression to its peak are the characteristics of SCI. By combining cerebrospinal fluid and MRI examinations, most patients can be definitely diagnosed. However, its etiology still depends on CTA and digital substraction angiography (DSA) examination. There is no effective treatment for SCI. At present, only a few treatment methods have been proposed for etiology.