Ischemic spinal cord lesions with abdominal aortic aneurysm are rare and are usually characterized by a single catastrophic event. The authors report a seventy-five-year-old woman who, over a period of three years, had three at tacks of acute neurologic deficit. The clinical features were those of bladder incontinence, a mixture of upper and lower motor neuron lower limb motor deficit, and patchy sensory loss with a sensory level at T10-12. Investigations revealed a large abdominal aortic aneurysm that had enlarged with time. This case, they believe, represents an example of recurrent ischemic myelopathy due to occlusion at the mouth of radicular arteries or recurrent embolic events in those vessels.
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