The three signals are: Sensory- signals that evoke feelings like temperature, touch, pain, and pressure. These may show bone growths called spurs that pushagainst spinal nerves. Damage to the spinal cord at the C5 vertebra also affects the vocal cords, biceps, and deltoid muscles in the upper arms. Careers. What is a right lateral disc extrusion at l3-l4 level that abutted the right l3 nerve root sleeve within neural foramen mean? Heterogenous means the appearance is different like salt and pepper. In equivocal cases, CT myelography can help localize the dural defect and conventional myelography shows real-time movement of CSF, so that other causes of intradural filling defect such as arachnoid cyst can be excluded (62). The patients neurologic symptoms markedly improved after supplemental vitamin B12 injections. . HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. Neurodegenerative Disease.Motor neuron diseases of the spinal cord represent a rare group of fatal progressive neurodegenerative diseases, including primary lateral sclerosis, spinocerebellar ataxia, iron neurodegeneration, Friedreich ataxia, and amyotrophic lateral sclerosis (ALS) (39). (a, b) Sagittal T2-weighted MR images demonstrate longitudinally extensive abnormal T2 hyperintensity extending from the lower thoracic cord to the conus medullaris (arrow) with prominent surrounding flow voids (arrowheads). Pain and stiffness in the neck, upper back or lower back. These include Gibbs (aka truncation) artifacts seen at high-contrast interfaces, respiratory motion, vascular pulsation, cerebrospinal fluid (CSF) pulsation, and magnetic field inhomogeneity or susceptibility artifact related to surgical implants (3). What causes spinal nerve impingement? (b) Sagittal CT myelogram demonstrates relative expansion of the cord at the T4 level (arrow) with focal cord thinning at the T3-T4 level (arrowhead), corresponding to the cord abnormality seen on the MR image. Depending on the cause of the compression, symptoms may develop suddenly or gradually, and they may require anything from supportive care to emergency surgery. The MRI is post cervical fusion of C4-C5. I highly recommend Dr. Corenman and the Steadman Clinic. Know why a new medicine or treatment is prescribed, and how it will help you. (a) Sagittal T2-weighted MR image demonstrates focal intramedullary abnormal SI with cord distortion at the T3-T4 level adjacent to slight cord expansion (arrow). (d) Intraoperative image obtained during T8-T10 laminectomies demonstrates findings seen on the MR images and DSA image. Anatomy. Object: The presence of intramedullary T2 high signal intensity changes in patients with cervical spondylotic myelopathy (CSM) indicates the existence of a chronic spinal cord compressive lesion. SACD in a 54-year-old man with progressive sensory and gait disturbance with mild cognitive slowing who was found to have a low serum vitamin B12 level. 4.Neurons are brain cells. The combined imaging features are typical of a demyelinating disease such as MS. Ventral refers. Severe Symptoms of Cervical Stenosis with Myelopathy. Neurosarcoidosis in a 52-year-old man with lower extremity weakness and fecal and urinary retention. J Neurosurg Spine. 2 level adr in2010. Hohenhaus M, Egger K, Klingler JH, Hubbe U, Reisert M, Wolf K. BMJ Open. Sudden injury from sports or an accident can result in a pinched nerve. A mass can include a tumor or bone fragment. A number of pathological abnormalities, including demyelination and neuroaxonal loss, occur in the MS spinal cord and are studied in vivo with magnetic resonance imaging (MRI). At MRI, there is typically extensive long-segment T2 hyperintensity. (c) Axial T2-weighted MR image in a different patient with suspected HIV myelopathy demonstrates hyperintensity in the dorsal columns (arrow), mimicking SACD. All responses are confidential. You have done more for me by answering my questions than any of the generic neurologists that Ive 30, No. In the initial phase, there may be a variable degree of enhancement. However, you may visit "Cookie Settings" to provide a controlled consent. And surgical outcome in cervical myelopathy have yielded conflicting results syrinx is a group of housed. Spinal cord compression is caused by any condition that puts pressure on your spinal cord. Filters. (b) Axial T2-weighted MR image shows that the cord appears to be apposed to the ventral aspect of the dura with no visible CSF ventral to the spinal cord (arrow). Pins and needles in hands and feet could originate from cord injury. Physical therapy is warranted to teach you the right exercises to ease your pain. One of the most common causes of spinal cord compression is the gradual wear and tear on the bones of the spine, known as osteoarthritis. your suggestion? Necessary cookies are absolutely essential for the website to function properly. (a) Sagittal T2-weighted MR image demonstrates a syrinx extending from C7 to the level of the T2-T3 disk space (arrow) with adjacent cord SI abnormality. Sagittal STIR (a), T1-weighted (b), and contrast-enhanced T1-weighted (c) MR images demonstrate a heterogeneous mildly enhancing intramedullary lesion in the upper thoracic cord, causing cord expansion (arrow). 1 What does spinal cord impingement mean? Spinal cord herniation in a 66-year-old man with a history of chronic back pain and acute onset of thoracic intrascapular pain. Johns Hopkins Medicine Virtual Advisors (Virtual Advisors) is a group of individuals who share their insights about the Johns Hopkins care experience. You must be logged in to reply to this topic. The Natural History of Cervical Spondylotic Myelopathy and Ossification of the Posterior Longitudinal Ligament: A Review Article. The cookie is used to store the user consent for the cookies in the category "Other. Not the same: Homogenous means the appearance is all the same, like a bowl of milk is all white or charcoal is all black. These could include: Incontinence. I am constantly tripping and falling. Lumbar spine mri shows:" the bone marrow signal is grossly homogeneous.there is no bone marrow edema,there is a left disc herniation." That was the reason for surgery.) While extremely rare, progressive cases of . During development, there's a disproportion between spinal cord growth and vertebral column growth. But the implications of . These cookies will be stored in your browser only with your consent. Figure 18d. Figure 9b. Predisposing factors include craniocervical junction abnormalities, previous spinal cord trauma, and spinal cord tumors. This cookie is set by GDPR Cookie Consent plugin. ALS is the most common type of motor neuron disease (49). Optimal machine learning methods for radiomic prediction models: Clinical application for preoperative T. Increased signal intensity of spinal cord on T2W magnetic resonance imaging for cervical spondylotic myelopathy patients: Risk factors and prognosis (a STROBE-compliant article). as a cause for any neurological deficit. This is causing mass effect on the anterior left surface of the cord and encroaching the foramen and could certainly affect the left sixth nerve root." The C6-7 fusion is solid. (d) Axial CT myelogram at the T3-T4 level demonstrates the center of the cord possibly extending through the anterior surface of the dural sac (arrow). Are nerve conduction studies (as opposed to SSEPs, and needle EMGS) only used to detect peripheral nerve issue VS. spinal nerves? (d) MR image shows mild expansion and patchy enhancement of the right optic nerve (arrowhead). 27, No. The cookie is used to store the user consent for the cookies in the category "Other. (a, b) Sagittal T2-weighted (a) and contrast-enhanced T1-weighted (b) MR images demonstrate cord T2 hyperintensity extending from the lower medulla to the C6 level associated with mild cord expansion (arrow in a) and heterogeneous enhancement (arrow in b). The aim of this review is to summarise and discuss recent advances in spinal cord MRI. For this journal-based SA-CME activity, the author M.J.L. The use of nonsteroidal anti-inflammatory (NSAID) drugs may help the patient regain some sensory and or motor function. This damage can result in temporary or permanent changes in sensation, movement, strength, and . Lab study results show greater sensory and motor function in those patients treated with stem cells for spinal cord damage. (c) Sagittal CT myelogram shows a ventrally displaced spinal cord that is closely apposed to the dorsal aspect of the vertebral bodies throughout the thoracic spine (arrowheads), with focal distortion of the posterior cord contour at the T3-T4 level with a transition in the cord caliber (arrow). The explanation and descriptions are easy to follow and so helpful in understanding the a variety of conditions covered.Thank you Dr Corenmen for providing such a valuable directory of information. Ask if your condition can be treated in other ways. (a, b) Sagittal short inversion time inversion-recovery (STIR) MR image (a) and MR image obtained after administration of contrast material (b) demonstrate T2 cord hyperintensity (arrow in a) and irregular patchy enhancement (arrowhead in b) secondary to extrinsic compression from surrounding disk bulge and degenerative change at the level of the most severe narrowing. dAVF usually manifests with poorly defined T2 hyperintensity and cord enlargement, which represent spinal cord edema. Imaging shows characteristic anterior kinking of the spinal cord with enlargement of the subarachnoid space dorsal to the cord (62) (Fig 18). This cookie is set by GDPR Cookie Consent plugin. Dr, post exam, says beginning stages of myelopathy. This pain is typically exacerbated by a recumbent position and may be related to secondary irritation or distention of the dura (43). The combined imaging features are typical of a demyelinating disease such as MS. Neoplastic versus nonneoplastic causes of intrinsic spinal cord SI abnormality. Copper deficiency myelopathy and subacute combined degeneration of the cord: why is the phenotype so similar? Find more COVID-19 testing locations on Maryland.gov. Spinal cord compression occurs when a mass places pressure on the cord. Figure 15a. (d) Axial CT myelogram at the T3-T4 level demonstrates the center of the cord possibly extending through the anterior surface of the dural sac (arrow). - A person no longer has brain functions. He was diagnosed with recurrent idiopathic TM after an extensive workup was negative for an alternate cause. Other uncategorized cookies are those that are being analyzed and have not been classified into a category as yet. The signal cable is a term used to describe the cable that connects your computers case to your computer monitor. Spinal cord and intracranial involvement in a 62-year-old woman with long-standing MS. (a, b) Sagittal STIR (a) and axial T2-weighted (b) MR images of the cervical and upper thoracic spine show areas of patchy and short-segment (<1.5 vertebral body length) hyperintensity with a peripheral wedge-shaped appearance (arrows). Viewer, http://www.webcir.org/revistavirtual/articulos/diciembre11/colombia/col_ingles_a.pdf, Nontraumatic Spinal Cord Compression: MRI Primer for Emergency Department Radiologists, White Matter Diseases with Radiologic-Pathologic Correlation, Incomplete Cord Syndromes: Clinical and Imaging Review, Understanding Pediatric Neuroimmune Disorder Conflicts: A Neuroradiologic Approach in the Molecular Era, Neuromyelitis Optica Spectrum Disorders: Spectrum of MR Imaging Findings and Their Differential Diagnosis, Abnormal Spinal Cord Signal: A Systematic Approach to Differentiate Myelitis from Its Mimics, Suspected Cord Compression: An MRI Primer for ED Radiologist, MOG Antibody Disease: Spectrum of Imaging Findings, Overlapping and Differentiating Features with ADEM and NMOSD, Acute Disseminated Encephalomyelitis (ADEM). Common symptoms of spinal cord compression include: Balance issues. (c) Axial T2-weighted MR image shows hyperintensity (arrow) affecting more than two-thirds of the cross-sectional area of the cord. The three signals are: Sensory- signals that evoke feelings like temperature, touch, pain, and pressure. Narrowing, impression, and deformity mean the same as compression in this sense- something, most likely bulging or herniated discs are pressing on the spinal cord in neck. C spine mri results normal? Figure 14a. Symptoms of a spinal cord injury corresponding to C4 vertebrae include: Damage to the spinal cord at the C5 vertebra affects the vocal cords, biceps, and deltoid muscles in the upper arms. Figure 19c. These bright spotty lesionsfocal internal areas of T2 hyperintensity that are at least as bright as CSF with corresponding low SI at T1-weighted imaginghave recently been shown to be highly specific to NMOSD and are seen in about one-half of patients (25,26). I assume that CFS is a typo for CSF. This is not bone marrow signal changes and there was no report of bone marrow changes on your report. A nerve root block at l3-4 would tr Dr. Susan Rhoads and another doctor agree. Unlike some of the higher cervical injuries, a patient with a C5 spinal cord injury will likely be able to breathe and speak on their own. i had spine mri done. Signal cable is used in data transmission applications that demand superior signal protection. Please note, we cannot prescribe controlled substances, diet pills, antipsychotics, or other commonly abused medications. The patients neurologic symptoms markedly improved after supplemental vitamin B12 injections. Decreased hydration leads to a loss of signal intensity on the T2 images which leads to darkening of the disc on the image (Figure 6). As the name implies, this syndrome is the result of damage to the central portion spinal cord and in the setting of trauma most commonly affects the cervical cord. Difficulty with fine motor skills, such as buttoning a shirt or grasping small objects. There is mild cord signal heterogeneity posteriorly also at C5-6 in the posterior midline. (c) Axial T2-weighted MR image shows hyperintensity (arrow) affecting more than two-thirds of the cross-sectional area of the cord. A rapidly repeating sequence of radiofrequency pulses produced by the scanner then causes excitation and resonance of protons. At MRI, there is usually long-segment nonexpansile T2 hyperintensity, which can be seen in all three entities. The occurrence of acute myelopathy in a nontrauma setting constitutes a medical emergency for which spinal MRI is frequently ordered as the first step in the patient's workup. During the exam, he or she will look for signs of a spinal compression, such as loss of sensation, weakness, and abnormal reflexes. The C3 vertebra is in line with the lower section of the jaw and hyoid bone, which holds the tongue in place. Answer: > Can effacement of CFS surrounding the spinal cord cause severe headaches? CSC is thought to represent pathological changes in the spinal cord detectable with histology that occur as a result of chronic compression 4). (c) Axial fluid-attenuated inversion-recovery (FLAIR) MR image of the brain demonstrates areas of bilateral patchy T2 or FLAIR high SI in a pericallosal and periventricular distribution (arrows). Acute Disseminated Encephalomyelitis.ADEM typically manifests as an acute monophasic illness after viral infection or vaccination, predominantly occurring in the pediatric population (1,14). Especially the abnormal signal. NMOSD in a 36-year-old woman. Arachnoid web in a 47-year-old man with a history of progressive paraparesis and lower extremity numbness. Please keep us informed of your progress. Clinical Features of Demyelinating Diseases. (a, b) Sagittal T2-weighted MR images demonstrate longitudinally extensive abnormal T2 hyperintensity extending from the lower thoracic cord to the conus medullaris (arrow) with prominent surrounding flow voids (arrowheads). A couple of points. Fusing the spine and decompressing the nerves around the spinal cord are beneficial in recovery from a cervical spinal cord injury. Cord ependymoma in a 25-year-old woman with a history of neurofibromatosis type 2 who presented with progressive back pain and leg numbness. . Pathological tissue usually has more water than normal brain so this is a good type to scan to pick this up. mri done yesterday so waiting for spine doctor to call for follow up. Neurosarcoidosis in a 52-year-old man with lower extremity weakness and fecal and urinary retention. There is involvement of both the gray and white matter in the brain and spinal cord; however, gray matter involvement is more evident in the spinal cord than in the brain at routine imaging (1,12,13). Other good body mechanics include sleeping on a firm mattress and sitting in a chair that supports the natural curves of your back. Hemangioblastoma is a well-demarcated highly vascular nonglial tumor (42). Once artifacts and extrinsic compression are excluded as possible causes of cord SI abnormality, the remaining cord SI alterations can be considered intrinsic to the spinal cord. This pattern is caused by the high-contrast interface of CSF with the spinal cord and can be minimized by increasing the number of phase-encoding steps, switching the frequency- or phase-encoding directions, or decreasing the field of view (3). Figure 17a. Advertisement cookies are used to provide visitors with relevant ads and marketing campaigns. (a, b) Images in a 50-year-old man with progressive spastic quadriplegia show diffuse cord atrophy through visualized segments of the cervical and upper thoracic spinal cord (a) with subtle T2 SI involving the central portion of the spinal cord (arrowhead in b). Spinal cord compression is caused by a condition that puts pressure on your spinal cord. Cervical stenosis is one such degenerative condition that may affect the spinal cord and lead to compromised coordination of the extremities. Change in the disc signal, or darkening of the signal, is associated with dehydration or loss of hydrogen ions within the disc. At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Conclusion: Thank you so much for taking the time to answer my questions about MRI results. C2-C3: There is a mild right C3 foraminal narrowing. The combined imaging features are typical of a demyelinating disease such as MS. Presented as an education exhibit at the 2018 RSNA Annual Meeting. By clicking Accept All, you consent to the use of ALL the cookies. The brain stem collects the nerve messages and sends them as well. The .gov means its official. Biomed Res Int. If you do not have radiating leg pain, the disc herniation may shrink over time and resorb. C3, C4, and C5 spinal cord injuries can be life-threatening and permanently alter ones lifestyle. Figure 1. He was diagnosed with recurrent idiopathic TM after an extensive workup was negative for an alternate cause. The combination of clinical history and imaging findings is typical of radiation myelopathy. Get regular exercise. Axial T2-weighted MR image (a), diffusion-weighted MR image (b), and apparent diffusion coefficient (ADC) map (c) show postoperative changes in the paraspinal soft tissues (arrows in a). Results: Following contrast administration no abnormal enhancement is seen. The different types of signals are sent out and received in different ways. Intraoperatively, this was confirmed to be related to arachnoiditis with webs without evidence of cord herniation. Other causes include occlusion related to aortic or cardiac interventions, trauma, systemic arteriopathy, or rarely fibrocartilaginous embolization (30,32,33). 96, Magnetic Resonance Imaging Clinics of North America, Vol. The spinal cord sends the nerve impulses from the brain to the muscle faster than the blink of an eye. The mass shows hemorrhagic products along the inferior aspect (arrowhead in a), demonstrating the hemosiderin cap sign. (b) Axial FLAIR image of the brain demonstrates additional T2 or FLAIR hyperintensity in the right thalamus (arrowhead). HISTORY: 43-year-old woman with motor and sensory changes as well as dysequilibrium and visual changes with significant short-term memory loss. C4-C5: There is postoperative change and there is a Figure 2b. Results: All subjects (19 male, 4 female; mean age, 26.3 7.4 years) demonstrated "pencil-like," central T2-hyperintense signal abnormalities in the spinal cord extending from the midthoracic . Keep your back as healthy as possible by maintaining a healthy weight, practicing good body mechanics, and getting regular exercise. 2010 Jan;12(1):59-65. doi: 10.3171/2009.5.SPINE08940. I dont have ED but usually can't "finish" sometimes I can with aggressive. The spinal cord is frequently affected in multiple sclerosis (MS), causing motor, sensory and autonomic dysfunction. CSF oligoclonal IgG bands are usually absent (14,23) (Table). government site. Figure 9a. This usually will mean that there is bulging of the lumbar disks, but you should not have and clinical symptoms as its very small. Neoplastic lesions of the spinal cord and spinal column are commonly categorized as intramedullary or extramedullary. (a) Sagittal T2-weighted MR image demonstrates long-segment hyperintensity (arrows) extending from the upper to mid thoracic cord without expansion. In the year since the most recent MRI, I have developed new pain recently on top of my normal chronic pain. Spinal cord compression can often be helped with medicines, physical therapy, or other treatments. When imaging findings are present, they are typically long-segment cervicothoracic lesions affecting more than 50% of the spinal cord cross-sectional area, with central spinal cord predominance with or without enhancement and mild cord expansion in the acute setting (1,27) (Figs 4, 8). (a, b) Sagittal T2-weighted (a) and contrast-enhanced T1-weighted (b) MR images demonstrate cord T2 hyperintensity extending from the lower medulla to the C6 level associated with mild cord expansion (arrow in a) and heterogeneous enhancement (arrow in b). Numbness, weakness, and/or cramping in the hands, arms or legs. The cookie is used to store the user consent for the cookies in the category "Analytics". Cervical MRI shows various degrees of central canal narrowing, foraminal narrowing, herniations ect. Acute cord infarct in a 60-year-old woman after thoracoabdominal aortic aneurysm repair. b. Such typical imaging findings in a patient with normal serum vitamin B12 levels should raise suspicion for alternate causes of SACD, such as nitrous oxide toxic effects, zinc toxic effects, or copper deficiency (4648). These result in a cord contour distortion that appears similar to cord herniation (Fig 19). You mention that there are a number of things that could cause abnormal signal. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. Video chat with a U.S. board-certified doctor 24/7 in a minute. Figure 8b. , etc.) This cookie is set by GDPR Cookie Consent plugin. What does spinal cord signal mean? Multisegmental spinal cord signal intensity changes on T2-weighted MR imaging are predictors of a poor outcome in terms of functional recovery rate in patients undergoing operations for CSM. Cord ependymoma in a 25-year-old woman with a history of neurofibromatosis type 2 who presented with progressive back pain and leg numbness. Because of the differing disease course and divergent therapeutic approach, it has become critical to differentiate NMOSD from MS when possible. 2. MRI demonstrates T2 hyperintensity involving the anterolateral columns with or without associated spinal cord atrophy. For these, please consult a doctor (virtually or in person). 2021 Nov 13;4(4):e1178. levoconvex torticollis, partial fusion of c2-3&c5-6, osteophyte complex at c2-3&c3-4 with narrowing of the l sided neural foramen, small r paracetamol disc herniation c2-3 with indentation nerve root. A metal wire or optical fiber that is used to transfer data. You will also see this message occasionally if your computer video card is malfunctioning and cannot send the proper video signal through the cable to your monitor. A systematic review. Symptoms of a spinal cord injury corresponding to C3 vertebrae include: Patients with C4 spinal cord injuries typically need 24 hour-a-day support to breathe and maintain oxygen levels. I live in Florida and I have recently been deemed permanently disabled and for that reason, I cant get diagnosed or treated down here because Rick Scott is not a nice guy, which makes him a horrible governor for people like me, which is exactly why I am planning to move to Colorado in the next few months. eCollection 2021 Dec. Medicine (Baltimore). Spinal cord injuries are traumatic for patients and their families. These may include a bone scan, myelogram (a specialX-ray or CT scan taken after injecting dye into the spinal column), and electromyography, or EMG, an electrical test of muscle activity. There is no mention of "a herniated disc" so I am unclear as to your surgeon's reference to it. What does increased T2 signal intensity mean? Sagittal MR images show multiple alternating light and dark parallel lines (arrow) at high-contrast interfaces, mimicking intrinsic cord SI abnormality or a syrinx. Unlike astrocytoma, it is a sharply defined encapsulated tumor and is associated with neurofibromatosis type 2 (42,43). Why are doctors able to reattach the nerves in a severed limb, but not a severed spinal cord? These cookies will be stored in your browser only with your consent. (a) Axial T2-weighted MR image shows hyperintensity in the lateral aspects of the cervical spinal cord (arrows) without enhancement or cord expansion. This website uses cookies to improve your experience while you navigate through the website. Neck or low back pain that radiates into your arms or legs is often a sign of impingement or pinching of a nerve as it emerges from your spinal cord. Will you please tell me what all that means? The correct thing to do is ask the physician who ordered the MRI to explain the findings to you as that person has all the history and clinical findin Mri of t spine yesterday. Other common causes include: Cervical vertebrae from C3 through C6 are also known as typical vertebrae since they share similar anatomical characteristics to the other vertebrae further down the spinal column. It carries most of the weight for a vertebra. Randomly orientated protons become aligned with the powerful magnetic field in the bore of the scanner. Bring someone with you to help you ask questions and remember what your provider tells you. 53, No. Arachnoid web in a 47-year-old man with a history of progressive paraparesis and lower extremity numbness. Epidemiology, Pathophysiology, and Diagnosis, MR findings in subacute combined degeneration of the spinal cord: a case of reversible cervical myelopathy, Teaching NeuroImage: inverted V sign in subacute combined degeneration of spinal cord, Imaging of the Spinal Cord: Classic Syndromes and Non-neoplastic Lesions, Copper deficiency myelopathy (human swayback). Researchers suggest that if peripheral nerve functioning is maintained after SCI, health complications can be significantly reduced and better prospects of rehabilitation and recovery can be assumed. Study design: Retrospective analysis of prospective data. (a) Axial T2-weighted MR image shows hyperintensity in the lateral aspects of the cervical spinal cord (arrows) without enhancement or cord expansion. But opting out of some of these cookies may affect your browsing experience. Created for people with ongoing healthcare needs but benefits everyone. On the contrary, hypointensity would be blacker in color. Figure 17b. MS in the spinal cord commonly affects the cervical region (1). T2/FLAIR images show the total amount of scar from MS from its onset. I have cervical myelopathy. See Fig. The MRI hyperintensity reflects the existence of lesions in the brain. Burning pain that spreads into arms, buttocks, or down the legs, called sciatica. There is abnormal T2 hyperintensity involving the anterior horns of the central gray matter, demonstrating the owls eye sign (arrowhead in a), with a corresponding area of low SI on the ADC map (arrowhead in b and c), suggesting impeded diffusion from acute spinal cord infarction. This entity tends to affects the dorsal columns and lateral corticospinal tracts, hence patients present with paresthesia of the hands and feet with loss of proprioception, which may progress to gait ataxia and even ataxic paraplegia in severe cases (44). Spondylotic myelopathy in a 40-year-old man with leg weakness. I am worried about bone cancer because I also read that somewhere. What sends away signals from the spinal cord and brain? (a) On a sagittal STIR image, hyperintensity involving the dorsal aspect of the cord extends from C1 to C6 (arrow). An increase in T2 signal intensity is often associated with chronic compression of the spinal cord, and it is well established that chronic compression results in structural changes to the spinal cord. (c) Axial fluid-attenuated inversion-recovery (FLAIR) MR image of the brain demonstrates areas of bilateral patchy T2 or FLAIR high SI in a pericallosal and periventricular distribution (arrows).
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