Case ReportsContralateral Middle Cerebral Artery Territory Infarction After Anterior Cervical Diskectomy and Fusion A Case ReportMcCartney, Christian MD1,a; Taylor, Joshua BS1; Kavadi, Niranjan MD1 Author Information 1University of Oklahoma Health Sciences Center and the Oklahoma City Veterans Affairs Hospital, Oklahoma City, Oklahoma aE-mail address for C. McCartney: [email protected] Investigation performed at Oklahoma City Veterans Affairs Hospital, Oklahoma City, Oklahoma Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (https://links.lww.com/JBJSCC/C55). JBJS Case Connector 13(1):e22.00574, January-March 2023. | DOI: 10.2106/JBJS.CC.22.00574 Buy Metrics Abstract Case: A 70-year-old man underwent anterior cervical diskectomy and fusion (ACDF) of the C3/4 and C4/5 levels by a left-sided approach to address canal stenosis causing right arm weakness. Intraoperative neuromonitoring demonstrated an intermittent decrease in left-sided motor signals. Postoperatively, the patient experienced a right middle cerebral artery stroke. At the 1-year follow-up, right arm strength had improved, but there was persistent left-sided weakness due to stroke. Conclusion: Although rare, possible intraoperative stroke should be considered when there are changes in motor or sensory evoked potentials. In addition, considerations should be given to pursue carotid stenosis screening in patients undergoing ACDF with known atherosclerosis or stroke history. Copyright © 2023 by The Journal of Bone and Joint Surgery, Incorporated
