Spinal cord infarction (SCI) is relatively uncommon, owing to the extensive anastomotic vascular network. Estimates of its occurrence are 1% to 2% of ischemic strokes. Posterior spinal artery infarction is far less common than anterior spinal artery infarction. PSA infarction produces loss of proprioception and vibratory sensation below the level of the injury. Weakness has been described but is typically mild and transient. Additionally thromboembolic phenomenon is a potential complication during intracranial aneurysm stenting. 

59-year-old female with history of multiple intracranial aneurysms which have been managed via endovascular coiling and stenting, who presented for evaluation of new-onset numbness and gait imbalance following successful embolization and flow diverter stent placement for newly diagnosed unruptured proximal basilar artery aneurysm visualized adjacent to R AICA origin, patient tolerated the procedure well without immediate complications, however after sedation weaned off patient started to experience numbness from mid-abdomen radiating to both feet. She denied focal motor weakness, urinary or bowel incontinence but endorsed gait imbalance. Neurologic examination showed intact muscle strength, loss of vibration and proprioception in both feet and ankles to mid-shin. Romberg was positive, gait was wide based. Symptoms and signs were suggestive of sensory ataxia and possible posterior cord involvement. MRI C-spine showed small focus of increased T2/STIR signal intensity within the dorsal midline spinal cord at the level of C2-3 consistent with punctate myelomalacia without disc herniation or central canal stenosis, MRI brain was unremarkable.