Wada Manabu, Nagasawa Hikaru, Yamaguchi Yoshitaka
Department of Neurology, Yamagata Prefectural Central Hospital, 1800 Aoyagi, Yamagata, Japan.
Case Rep Neurol Med. 2020 Oct 5;2020:8836561. doi: 10.1155/2020/8836561. eCollection 2020.
Spinal cord infarction (SCI) is rare, difficult to diagnose, and often fails to be detected by diffusion-weighted imaging (DWI) of spinal cord magnetic resonance imaging (MRI). Because the clinical features of SCI can vary widely, diagnosis during the acute phase of SCI is often challenging for clinicians. Although SCI shares similar etiologies with cerebral infarction, the characteristics of SCI without vessel dissection remain largely unknown. We present two older patients with mild neurological symptoms who each presented with a small, unilateral, upper cervical cord lesion, which was detected by thin-section, coronal DWI of brain MRI. Both unilateral small lesions were localized in the right lateral funiculus, and each patient showed good prognosis. The anatomical findings suggested that the pial collateral network surrounding the cervical cord contributed to lesion formation. Small and localized lesions have been associated with mild neurological symptoms and better short-term prognosis. The present report indicated that the use of thin-section coronal DWI when performing brain MRI may be helpful for the diagnosis of small, unilateral, upper cervical cord infarctions.
脊髓梗死（SCI）较为罕见，诊断困难，脊髓磁共振成像（MRI）的扩散加权成像（DWI）常无法检测到。由于SCI的临床特征差异很大，在SCI急性期进行诊断对临床医生来说往往具有挑战性。尽管SCI与脑梗死有相似的病因，但无血管夹层的SCI特征在很大程度上仍不清楚。我们报告了两名有轻微神经症状的老年患者，他们各自出现一个小的、单侧的颈上段脊髓病变，通过脑部MRI的薄层冠状位DWI检测到。两个单侧小病变均位于右侧侧索，且每位患者预后良好。解剖学发现提示，围绕颈段脊髓的软膜侧支网络促成了病变形成。小的局限性病变与轻微神经症状及较好的短期预后相关。本报告表明，在进行脑部MRI时使用薄层冠状位DWI可能有助于诊断小的、单侧的颈上段脊髓梗死。
