A 62-year-old diabetic women developed acute quadriparesis. Her first symptom was clumsiness of the right limbs, which was followed shortly after by quadriparesis with severe left-sided symptoms. Sensory examination showed pinprick and thermal sensation deficits below the left T6 and right T8 dermatomes. An intramedullary infarction in the cervical cord at C5 to C6 levels was demonstrated by serial magnetic resonance imaging (MRI) studies with Gadolinium-DTPA (Gd-DTPA) enhancement. Based on the findings from this patient and 20 patients with spinal cord infarction reported in the literature, it was concluded that spinal cord infarct lesions are characterized by negative Gd-DTPA enhancement at the acute and chronic stages and positive enhancement at the subacute stage, 1 to 4 weeks after the onset of infarction.