[MRI findings of cervical cord injury. A case report of long-term follow-up].

A 63 year-old male, who sustained anterior cervical cord injury in a fall on his back during skiing, was consecutively examined by MRI from acute, up to the chronic stage. Right after the fall (2.5 hours later) the injured cord showed high intensity in T2 weighted images. This high intensity area stayed the same up to the chronic stage (6 months later). T1 weighted SE images showed no parenchymal change in the acute stage, but 3 months later a low intensity area appeared in the damaged cord. Thereafter, the injured cord exhibited localized low intensity on T1 weighted images, and high intensity on T2 weighted images, at subsequent MRI examinations. During the course of the examinations no significant neurological recovery was observed. Referring to the findings of our experimental cord injury studies, the high intensity in the T2 weighted images of the acute stage represents hemorrhagic necrotic tissue with edema, while those of the chronic stage suggest myelomalacia, and surrounding gliotic tissue. The low intensity in the T1 weighted images of the chronic stage reflects also this myelomalacia itself. We conclude that MRI of cervical cord injury is a useful diagnostic tool, not only delineating the level of the cord injury, but also aiding in the prognosis.