Skip to main content
AAPM&R 2025 Main banner
JFK
Final Program


Official Program
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
On Demand
On Demand
In-Person
In-Person
Livestream
Livestream
Invite Only
Invite Only
Ticketed
Ticketed
Coffee Break
Coffee Break
Meal
Meal
Reception
Reception
Rate ePoster

Neurological Rehabilitation

Inpatient Rehabilitation of a Patient with Spinal Cord Injury Secondary to Hemorrhage of Arterio-Venous Malformation (AVM): A Case Report.

Thursday, October 23, 2025
12:45 PM - 2:15 PM MT
Location: Kiosk 6

    Poster Presenter(s)

  • August Frank, MD

    Resident Physician
    Schwab Rehabilitation Hospital & Care Network/University of Chicago PM&R Program
    Chicago, Illinois

    • Co-Author(s)

  • Christian Wirawan, DO

    Resident
    Schwab Rehabilitation/University of Chicago
    Chicago, Illinois

  • RL

    Raymond Lee, MD

    attending physician
    Schwab Rehabilitation Hospital & Care Network/University of Chicago PM&R Program
    Chicago, Illinois

Disclosure(s):
August Frank, MD: No financial relationships to disclose
Christian Wirawan, DO: No financial relationships to disclose
Case Diagnosis: 59-year-old male with subarachnoid hemorrhage into the posterior fossa extending down to the left C5.

Case Description or Program Description: Patient is a 59-year-old male with chronic obstructive pulmonary disease, polysubstance use disorder (on suboxone), and previous right frontal traumatic brain injury who presented with altered mentation, fevers, and new left sided weakness. Initial CT head was negative, but repeat CT head showed posterior fossa subarachnoid hemorrhage and medullary intraparenchymal hemorrhage. Brain and C-spine MRI showed further hemorrhage specifically near the left C5. Neurosurgery performed C3-C6 laminectomy for left sided decompression and created an AV fistula. The patient was admitted to rehab for left hemiplegia and allodynia.

Setting: Inpatient Rehabilitation Hospital

Assessment/Results: During rehabilitation, the patient was treated for dysphagia (increased from NDD2 to NDD4 diet), orthostatic hypotension (unable to tolerate out of bed activities but progressed to ambulate short distances), and allodynia (weaned all opiates and titrated down neuropathic medications). Therapy teams employed spinal cord and stroke rehabilitation strategies, including hemi-techniques for self-care, swallowing and memory strategies, and transfer education.

Discussion (relevance): Vascular lesions of the spine only account for ~2% of vascular neurological pathologies. Cervical lesions are less common amongst spinal vascular pathology. While rare, understanding pathology is crucial as inappropriate diagnosis of hemiplegia can lead to poor prognosis.

Conclusions: No etiology was identified for the patient’s arteriovenous malformation, however he did successfully complete inpatient rehabilitation. Like most spinal cord injuries, he has a new baseline and requires around the clock care. He was discharged to a skilled nursing facility.