Introduction: Spinal cord infarction corresponds to all the clinical manifestations secondary to ischemia of part or all of the spinal cord, whether sudden or progressive. It is a rare condition with a difficult diagnosis affecting only 1.2% of patients admitted to the neurovascular pathologies department. It is most frequently located in the territory of the anterior spinal artery (66.7%).

Observation: 43-year-old patient with a lifestyle of repeatedly carrying heavy weights on the head, presenting with neck pain radiating to the upper limbs and tetra paresis. The clinic is characterized by anterior spinal artery syndrome, a lesional and sublesional syndrome and the spinal MRI revealed an extensive T2 hyper signal localized at the level of the anterior horn producing the characteristic appearance of snake eyes evoking an infarction in the territory of the anterior spinal artery.

Conclusion: It is a diagnosis which remains difficult and is based on the comparison of clinical and para-clinical data.