Spinal cord infarction has been reported to be a rare disease comprising of only 1% to 2% of all ischemic strokes. The finding of a dissecting vertebral artery aneurysm combined with positive for Antinuclear Antibodies (ANA) presenting at first as a Spinal Cord Infarction (SCI) is a unique case of a Central Nervous System (CNS) Systemic Lupus Erythematosus (SLE). We report a case of a 54-year-old female from the Philippines who presented with bilateral lower extremity weakness and urinary incontinence. Magnetic Resonance Imaging (MRI) of the thoracolumbar spine revealed focal intrinsic signal abnormalities, indicative of restricted diffusion, involving T11 midbody down to the apex of the conus, consistent with an acute infarction. Cranial Computed Tomography (CT) angiography also showed a sacculo-fusiform aneurysm at the junction of the 3rd and 4th segment of the left vertebral artery with probable dissection, respectively. The patient was also noted to have increased Cerebrospinal Fluid (CSF) Immunoglobulin G (IgG) and positive for ANA.
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