Demographics:
61 years old, Female
Indication:
New truncal and bilateral arm numbness, right arm weakn...
New truncal and bilateral arm numbness, right arm weakness, baseline bilateral leg weakness
Findings
- Extensive T2/STIR signal hyperintensity, with areas of intensity greater than that of CSF, extending from the caudal medulla through the level of C6-C7, with areas of patchy T2/STIR signal hyperintensity in the cord inferiorly spanning C7-T3
- Mild associated cord expansion
- Patchy areas of associated enhancement
- Overall mild multilevel degenerative changes with straightening of the usual cervical lordosis. Left eccentric disc osteophyte complex at C5-C6 in combination with uncovertebral spurring contributes to moderate left and mild right neural foraminal stenosis and mild spinal canal stenosis. Right eccentric disc osteophyte complex at C6-C7 in combination with uncovertebral spurring contributes to mild right neural foraminal stenosis
Diagnosis
Neuromyelitis optica (NMO)
Sample Report
Extensive T2/STIR signal hyperintensity extending from the caudal medulla through the level of C6-C7, with areas of patchy T2/STIR signal hyperintensity extending further inferiorly to the level of T3. Associated mild cord expansion and patchy enhancement. This appearance is most consistent with a demyelinating (particularly neuromyelitis optica spectrum disorders) or infectious process. Neoplasm is considered less likely given extent of involvement, enhancement pattern, and relatively mild associated cord expansion; however, recommend followup imaging to monitor for response to treatment.
Discussion
References