Anterior spinal artery syndrome presenting as cervical myelopathy in a patient with subclavian steal syndrome.

The anterior spinal artery syndrome (ASAS), described by Preobraschenski in 1908,1 is characterized by bilateral spastic paraparesis and dissociated sensory deficits involving bilateral loss of temperature and pain sensation but preserved proprioception and touch. The ASAS typically develops acutely, over minutes to hours. While initially linked to infections, in particular syphilis, many other etiologies are now recognized, including aortic atheromatous disease and thromboembolic phenomenon. We report a case of ASAS in a patient with a steal phenomenon secondary to a right-sided aortic arch with interruption of the left subclavian artery (SCA).