6ER-043 Case report: spinal cord infarct secondary to vaping?

<h3>Background and Importance</h3> Smoking cigarettes is a well-recognised risk associated with stroke.¹ Worldwide, the healthcare systems have implemented measures to reduce the prevalence of smoking cigarettes, while the market of electronic cigarettes (vaping) has been expanding. Although vaping is a possible strategy to help smokers quit, it is also heavily marketed towards children and non-smokers. The risk associated with vaping and stroke has been described. Spinal cord injury due to illicit drug misuse has been reported. <h3>Aim and Objectives</h3> We report the case of a young male, non-smoker, heavy vaper, who sustained injury to the spinal cord as a result of infarct. <h3>Material and Methods</h3> Retrospective review of patient’s clinical case notes. <h3>Results</h3> A 21-year-old male, with no known comorbidities. Patient says never having had smoked cigarettes; smokes e-cigarettes ‘all the time’ estimating and equivalent of 100 cigarettes per day. While at work patient felt a sharp pain to the neck. Shortly after felt weak to his arms and legs, felt clammy and short of breath. Was taken to the Emergency Department where he required supported ventilation and tracheostomy. MRI of the whole spine diagnoses spinal cord infarct at C2-C5 level with hyper acute inset was made. No other injuries were noted. Investigations including viral serology, lumbar puncture with CSF analysis and coagulopathies studies were all unremarkable. The patient was referred to a rehabilitation centre for a comprehensive rehabilitation programme. At admission peripheral neurological examination revealed incomplete tetraplegia AIS D at C3 level, as per the International Standards for Neurological Classification of Spinal Cord Injury, in central cord syndrome type of injury, with no hand function. <h3>Conclusion and Relevance</h3> Spinal cord infarct remains an uncommon cause of spinal cord injury, compared to traumatic injury and other non-traumatic causes (e.g. infection, spinal tumours). The more recent use of e-cigarettes and its possible impacts in public health, including morbidity and mortality, has not been yet fully described. Acute spinal cord ischaemia is life changing for the individual and expected clinical outcomes are still unclear. <h3>References and/or Acknowledgements</h3> Klein AP, Yarbrough K, Cole JW. Stroke. Smoking and vaping: the no-good, the bad and the ugly. <i>Ann Public Health Res</i>. 2021;<b>8</b>(1):1104. Epub 2021 Feb 18. PMID: 34322688; PMCID: PMC8315328. <h3>Conflict of Interest</h3> No conflict of interest