The diagnosis of anterior spinal artery syndrome can be made with high accu
racy by thorough clinical examination in combination with typical magnetic
resonance imaging findings, Sudden onset of tetra- or paraparesis and disso
ciated sensory loss with bladder dysfunction are the leading clinical signs
. We discuss clinical and radiologic findings in an adolescent presenting w
ith anterior spinal artery syndrome. The laboratory results showed a heredi
tary protein S deficiency.