Conway Brittani L, Clarke Michelle J, Kaufmann Timothy J, Flanagan Eoin P
Department of Neurology, Mayo Clinic, Rochester, MN, USA.
Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA.
Mult Scler Relat Disord. 2017 Jan;11:62-64. doi: 10.1016/j.msard.2016.12.004. Epub 2016 Dec 9.
Cervical spondylotic myelopathy is a common cause of myelopathy and may mimic transverse myelitis. We report a 55 year-old lady with subacute myelopathy initially treated with glatiramer acetate for suspected clinically isolated syndrome. MRI head and spine revealed a single short cervical cord T2-hyperintense lesion with enhancement just below a region of moderate stenosis. Cerebrospinal fluid revealed elevated oligoclonal bands. Repeat MRI 7 months later showed persistent enhancement. Dynamic MRI revealed cord compression during extension. Surgical decompression resulted in marked clinical and radiologic improvement. This case highlights the utility of extension MRI in cervical myelopathy of uncertain etiology.
脊髓型颈椎病是脊髓病的常见病因，可能类似横贯性脊髓炎。我们报告一位55岁女性，患有亚急性脊髓病，最初因疑似临床孤立综合征而接受醋酸格拉替雷治疗。头颅和脊柱MRI显示颈髓有一个单一的短T2高信号病变，在中度狭窄区域下方有强化。脑脊液显示寡克隆带升高。7个月后复查MRI显示强化持续存在。动态MRI显示伸展时脊髓受压。手术减压导致临床和影像学显著改善。该病例突出了伸展位MRI在病因不明的颈髓病中的作用。
