Spinal cord infarction (SCI) accounts for only 1% to 2% of all ischemic strokes and 5% to 8% of acute myelopathies. Magnetic resonance imaging (MRI) holds a role in ruling out non-ischemic etiologies, but the diagnostic accuracy of this procedure may be low in confirming the diagnosis, even when extensive cord lesions are present. Indeed, T2 changes on MRI can develop over hours to days, thus accounting for the low sensitivity in the hyperacute setting (ie, within 6 hours from symptom onset). For these reasons, SCI remains a clinical diagnosis. Despite extensive diagnostic work-up, up to 20% to 40% of SCI cases are classified as cryptogenic. Here, we describe a case of cryptogenic longitudinally extensive transverse myelopathy due to SCI, with negative MRI and diffusion-weighted imaging at 9 hours after symptom onset.

Hyperacute extensive spinal cord infarction and negative spine magnetic resonance imaging: a case report and review of the literature / G. Costamagna, M. Meneri, E. Abati, R. Brusa, D. Velardo, D. Gagliardi, E. Mauri, C. Cinnante, N. Bresolin, G. Comi, S. Corti, I. Faravelli. - In: MEDICINE. - ISSN 0025-7974. - 99:43(2020 Oct 23).

Hyperacute extensive spinal cord infarction and negative spine magnetic resonance imaging: a case report and review of the literature

G. Costamagna
Primo
;
M. Meneri;E. Abati;R. Brusa;D. Gagliardi;E. Mauri;C. Cinnante;N. Bresolin;G. Comi;S. Corti
Penultimo
;
I. Faravelli
Ultimo
2020-10-23

Abstract

Spinal cord infarction (SCI) accounts for only 1% to 2% of all ischemic strokes and 5% to 8% of acute myelopathies. Magnetic resonance imaging (MRI) holds a role in ruling out non-ischemic etiologies, but the diagnostic accuracy of this procedure may be low in confirming the diagnosis, even when extensive cord lesions are present. Indeed, T2 changes on MRI can develop over hours to days, thus accounting for the low sensitivity in the hyperacute setting (ie, within 6 hours from symptom onset). For these reasons, SCI remains a clinical diagnosis. Despite extensive diagnostic work-up, up to 20% to 40% of SCI cases are classified as cryptogenic. Here, we describe a case of cryptogenic longitudinally extensive transverse myelopathy due to SCI, with negative MRI and diffusion-weighted imaging at 9 hours after symptom onset.
Settore MED/26 - Neurologia
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/781707
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