Posterior Spinal Artery Infarction Following Venoarterial Extracorporeal Membrane Oxygenation and Microaxial Flow Pump Support in Influenza A Virus‐Induced Fulminant Myocarditis

Spinal cord infarction usually affects the anterior spinal artery territory, and posterior spinal artery infarction is rare. A 53‐year‐old woman was placed on venoarterial extracorporeal membrane oxygenation and microaxial flow pump support for influenza A virus‐induced fulminant myocarditis. There was bilateral lower limb weakness and sensory disturbance after discontinuation of mechanical supports. Magnetic resonance imaging of the spinal cord revealed symmetrical T2‐hyperintense lesions in the posterior columns from T4 to T11, which were compatible with posterior spinal artery infarction. Laboratory tests excluded autoimmune, infectious, and metabolic etiologies. Despite persistent numbness, motor function improved with rehabilitation. The mechanism of posterior spinal artery infarction may have involved spinal hypoperfusion from the watershed phenomenon and altered aortic hemodynamics due to the dual mechanical support. Posterior spinal artery infarction is an under‐recognized neurological complication of mechanical supports because of mild motor dysfunction. Early imaging evaluation can be important in patients with new neurological deficits.