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Magnetic resonance imaging findings within the posterior and lateral columns of the spinal cord extended from the medulla oblongata to the thoracic spine in a woman with subacute combined degeneration without hematologic disorders: a case report and review of the literature.

Rabhi S, Maaroufi M, Khibri H, Belahsen F, Tizniti S, Berrady R, Bono W - J Med Case Rep (2011)

Bottom Line: Subacute combined degeneration of the spinal cord is a rare cause of demyelination of the dorsal and lateral columns of the spinal cord and is a neurological complication of vitamin B12 deficiency.We present a case of cobalamin deficiency in a 29-year-old Moroccan woman who presented with subacute combined degeneration without evidence of anemia or macrocytosis.The patient was treated with vitamin B12 supplements and showed improvement in her clinical symptoms.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Internal Medicine, Hassan II University Hospital, Fez, Morocco. rabhisamira@gmail.com.

ABSTRACT

Introduction: Subacute combined degeneration of the spinal cord is a rare cause of demyelination of the dorsal and lateral columns of the spinal cord and is a neurological complication of vitamin B12 deficiency. Subacute combined degeneration without anemia or macrocytosis is rare.

Case presentation: We present a case of cobalamin deficiency in a 29-year-old Moroccan woman who presented with subacute combined degeneration without evidence of anemia or macrocytosis. Magnetic resonance imaging of the spinal cord demonstrated abnormal hyperintense signal changes on T2-weighted imaging of the posterior and lateral columns from the medulla oblongata to the thoracic spine. A diagnosis of subacute combined degeneration of the spinal cord was considered and confirmed by low serum cobalamin. The patient was treated with vitamin B12 supplements and showed improvement in her clinical symptoms.

Conclusion: Physicians should diagnose subacute combined degeneration in patients early by having a high index of suspicion and using diagnostic tools such as magnetic resonance imaging.

No MeSH data available.


Related in: MedlinePlus

Sagittal T2-weighted MRI scan showing the dorsal spinal cord with hyperintensity involving the posterior and lateral columns before treatment.
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Figure 4: Sagittal T2-weighted MRI scan showing the dorsal spinal cord with hyperintensity involving the posterior and lateral columns before treatment.

Mentions: The initial MRI examination of the cervical and dorsal spine was performed using a 1.5-T unit and showed an area of hyperintensity involving the dorsal and lateral columns from the medulla oblongata (Figure 1) to the thoracic spine (Figure 2, Figure 3 and Figure 4) on T2-weighted images. This area was not enhanced after the addition of gadolinium. The axial images revealed involvement of the posterior and lateral columns bilaterally (Figures 4 and 5), which was highly suggestive of SCD. The serum vitamin B12 level was collapsed to 25 pg/mL (normal range, 180 to 914 pg/mL), and her serum vitamin E level was normal.


Magnetic resonance imaging findings within the posterior and lateral columns of the spinal cord extended from the medulla oblongata to the thoracic spine in a woman with subacute combined degeneration without hematologic disorders: a case report and review of the literature.

Rabhi S, Maaroufi M, Khibri H, Belahsen F, Tizniti S, Berrady R, Bono W - J Med Case Rep (2011)

Sagittal T2-weighted MRI scan showing the dorsal spinal cord with hyperintensity involving the posterior and lateral columns before treatment.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3094295&req=5

Figure 4: Sagittal T2-weighted MRI scan showing the dorsal spinal cord with hyperintensity involving the posterior and lateral columns before treatment.
Mentions: The initial MRI examination of the cervical and dorsal spine was performed using a 1.5-T unit and showed an area of hyperintensity involving the dorsal and lateral columns from the medulla oblongata (Figure 1) to the thoracic spine (Figure 2, Figure 3 and Figure 4) on T2-weighted images. This area was not enhanced after the addition of gadolinium. The axial images revealed involvement of the posterior and lateral columns bilaterally (Figures 4 and 5), which was highly suggestive of SCD. The serum vitamin B12 level was collapsed to 25 pg/mL (normal range, 180 to 914 pg/mL), and her serum vitamin E level was normal.

Bottom Line: Subacute combined degeneration of the spinal cord is a rare cause of demyelination of the dorsal and lateral columns of the spinal cord and is a neurological complication of vitamin B12 deficiency.We present a case of cobalamin deficiency in a 29-year-old Moroccan woman who presented with subacute combined degeneration without evidence of anemia or macrocytosis.The patient was treated with vitamin B12 supplements and showed improvement in her clinical symptoms.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Internal Medicine, Hassan II University Hospital, Fez, Morocco. rabhisamira@gmail.com.

ABSTRACT

Introduction: Subacute combined degeneration of the spinal cord is a rare cause of demyelination of the dorsal and lateral columns of the spinal cord and is a neurological complication of vitamin B12 deficiency. Subacute combined degeneration without anemia or macrocytosis is rare.

Case presentation: We present a case of cobalamin deficiency in a 29-year-old Moroccan woman who presented with subacute combined degeneration without evidence of anemia or macrocytosis. Magnetic resonance imaging of the spinal cord demonstrated abnormal hyperintense signal changes on T2-weighted imaging of the posterior and lateral columns from the medulla oblongata to the thoracic spine. A diagnosis of subacute combined degeneration of the spinal cord was considered and confirmed by low serum cobalamin. The patient was treated with vitamin B12 supplements and showed improvement in her clinical symptoms.

Conclusion: Physicians should diagnose subacute combined degeneration in patients early by having a high index of suspicion and using diagnostic tools such as magnetic resonance imaging.

No MeSH data available.


Related in: MedlinePlus