Intikhab Osama, Cristiano Brian, Tehrani Ali, Zeiler Steven, Felling Ryan J, Gailloud Philippe
Division of Interventional Neuroradiology, The Johns Hopkins University, Baltimore, MD, USA.
Department of Neurology, The Johns Hopkins University, Baltimore, MD, USA.
Interv Neuroradiol. 2024 Aug 7:15910199241272610. doi: 10.1177/15910199241272610.
Ascertaining the etiology of cervical spinal cord dysfunction presents a challenge to clinicians, as the list of differential diagnoses is extensive. Although compressive and inflammatory disorders are common and should be considered immediately, vascular causes are similarly important and acute. The overlap of clinical, magnetic resonance imaging, and cerebrospinal fluid features among the causes of myelopathies may lead to erroneous diagnoses. Such errors may be compounded if routine vascular imaging does not reveal the underlying vasculopathy. We present here three cases in which computed tomography angiography and magnetic resonance angiogram could not clarify the nature of an acute myelopathy, whereas digital subtraction angiography established the diagnosis of spinal cord ischemia.
确定颈脊髓功能障碍的病因对临床医生来说是一项挑战,因为鉴别诊断的范围很广。虽然压迫性和炎症性疾病很常见,应立即予以考虑,但血管性病因同样重要且起病急。脊髓病各种病因之间临床、磁共振成像和脑脊液特征的重叠可能导致错误诊断。如果常规血管成像未显示潜在的血管病变,这种错误可能会更加复杂。我们在此介绍三例病例,其中计算机断层血管造影和磁共振血管造影未能明确急性脊髓病的性质,而数字减影血管造影确诊为脊髓缺血。