Zhang Qiao-Yu, Xu Lin-Ying, Wang Ming-Li, Cao Hua, Ji Xiao-Fei
Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China.
Department of Neurology, Nanchuan People's Hospital Affiliated to Chongqing Medical University, Chongqing 408400, China.
World J Clin Cases. 2023 Mar 26;11(9):2074-2083. doi: 10.12998/wjcc.v11.i9.2074.
Infarction of the conus medullaris is a rare form of spinal cord infarction. The first symptom is usually acute non-characteristic lumbar pain, followed by lower limb pain, saddle numbness, fecal incontinence, and sexual dysfunction. Spontaneous conus infarction with "snake-eye appearance" on magnetic resonance imaging has rarely been reported.
We report a 79-year-old male patient with spontaneous conus infarction who had acute lower extremity pain and dysuria as the first symptoms. He did not have any recent history of aortic surgery and trauma. Magnetic resonance imaging revealed a rare "snake-eye appearance." In addition, we reviewed the literature on 23 similar cases and summarized the clinical features and magnetic resonance manifestations of common diseases related to the "snake-eye sign" to explore the etiology, imaging findings, and prognosis of spontaneous conus infarction.
We conclude that acute onset of conus medullaris syndrome combined with "snake-eye appearance" should be strongly suspected as conus medullaris infarction caused by anterior spinal artery ischemia. This special imaging manifestation is helpful in the early diagnosis and treatment of conus infarction.
脊髓圆锥梗死是一种罕见的脊髓梗死形式。首发症状通常为急性非特异性腰痛，随后出现下肢疼痛、鞍区麻木、大便失禁和性功能障碍。磁共振成像显示为“蛇眼征”的自发性脊髓圆锥梗死鲜有报道。
我们报告一例79岁男性自发性脊髓圆锥梗死患者，首发症状为急性下肢疼痛和排尿困难。他近期无主动脉手术及外伤史。磁共振成像显示出罕见的“蛇眼征”。此外，我们回顾了23例类似病例的文献，并总结了与“蛇眼征”相关常见疾病的临床特征及磁共振表现，以探讨自发性脊髓圆锥梗死的病因、影像学表现及预后。
我们得出结论，脊髓圆锥综合征急性起病并伴有“蛇眼征”，应高度怀疑为脊髓前动脉缺血所致的脊髓圆锥梗死。这种特殊的影像学表现有助于脊髓圆锥梗死的早期诊断和治疗。
