A case of paraplegia was due to a ruptured aneurysm of the distal posterior inferior cerebellar artery. The paraplegia was caused by a unilateral lesion located between the cervicomedullary junction and the C2 level, where it involved both crossed and uncrossed pyramidal fibres projecting to the lower extremities. Since a vascular lesion near the cervicomedullary junction is likely to be missed, special attention should be paid to this region when investigating subarachnoid haemorrhage with paraplegia.
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