**5.4 Posterior cord syndrome**

Posterior cord syndrome (PCS) has an incidence of roughly <1% [95, 99]. Like ACS it carries a very poor prognosis. The causes of PCS include vascular compromise to the posterior spinal artery, trauma, multiple sclerosis (MS), vitamin B12 deficiency, and syphilis. Since PCS affects the posterior aspect of the spinal cord containing dorsal column fibers, one typically sees presentations that involve loss of proprioception and vibratory sensation with motor function being preserved. Patients occasionally will have sensation of "electric shocks" running down their spine, which is known as Lhermitte's sign and can indicate MS or a metabolic deficiency [121, 128]. CTA might allow for rapid diagnosis of vascular comprise/ threat and allow for emergent treatment. However, MRI imaging showing infarctions is the most reliable method of confirming the diagnosis [99]. Once the underlying pathology is treated, PCS management will require rigorous physical and occupational rehabilitation course [121].
