# Sulcal artery syndrome; a pain predominant presentation

## TL;DR

A man with a history of Erb’s palsy experienced severe arm pain linked to spinal cord and vertebral artery issues.

## Contribution

The paper presents a novel hypothesis for the absence of sensorimotor signs in spinal cord infarction.

## Key findings

- A 41-year-old man with Erb’s palsy had severe bilateral arm pain and spinal cord T2 hyperintensity.
- Imaging showed an occluded left vertebral artery to the V4 segment.
- A hypothesis is proposed for the lack of sensorimotor signs in spinal cord infarction.

## Abstract

A 41-year-old man with a neonatal history of Erb’s palsy presented with severe bilateral gnawing radicular arm pain. A detailed neurological examination detected no abnormality. Imaging revealed right hemi spinal cord T2 hyperintensity together with an occluded left vertebral artery to the V4 segment. The clinical syndromes and mechanisms of spinal cord infarction are discussed. A hypothesis for the lack of sensorimotor signs is put forward.