Takeshita Sho, Ogata Toshiyasu, Mera Hidekazu, Tsugawa Jun, Fukae Jiro, Tsuboi Yoshio
Department of Neurology, Faculty of Medicine, Fukuoka University.
Rinsho Shinkeigaku. 2016 May 31;56(5):352-5. doi: 10.5692/clinicalneurol.cn-000858. Epub 2016 Apr 19.
An 80-year-old woman was admitted to our hospital with acute onset of flaccid paraplegia and sensory and urinary disturbances that developed soon after acute pain in her lower back and leg. Neurological examination revealed, severe flaccid paraplegia, bladder and rectal disturbances and dissociated sensory loss below the level of L1 spinal cord segment. MR imaging with T2 weighted imaging (T2WI) and diffusion weighted imaging (DWI) on day 2 showed hyper signal intensity in the spinal cord at the vertebral level of L1 while initial apparent diffusion coefficient (ADC) showed decreased signal intensity in the lesion. We diagnosed spinal cord infarction, and anticoagulant and neuroprotective agents were administrated. Serial MRI findings revealed that the DWI signal of the lesion attenuated with time, and pseudo-normalization of the ADC occurred approximately 1 month after onset. These findings were similar to those seen in brain infarction. Our patient demonstrated serial MRI changes of spinal cord infarction showing anterior spinal cord syndrome.
一名80岁女性因急性弛缓性截瘫、感觉及排尿障碍入院,这些症状在其下背部和腿部急性疼痛后不久出现。神经系统检查发现,严重弛缓性截瘫、膀胱和直肠功能障碍以及L1脊髓节段水平以下的分离性感觉丧失。发病第2天进行的T2加权成像(T2WI)和扩散加权成像(DWI)的磁共振成像显示,L1椎体水平脊髓呈高信号强度,而初始表观扩散系数(ADC)显示病变处信号强度降低。我们诊断为脊髓梗死,并给予抗凝剂和神经保护剂治疗。系列磁共振成像结果显示,病变的DWI信号随时间减弱,发病约1个月后ADC出现假性正常化。这些发现与脑梗死所见相似。我们的患者表现出脊髓梗死的系列磁共振成像变化,显示为脊髓前动脉综合征。