Case Report| Volume 20, ISSUE 11, P1630-1632, November 2013

Download started.


Diffusion weighted imaging with trace diffusion weighted imaging, the apparent diffusion coefficient and exponential images in the diagnosis of spinal cord infarction


      A 73-year-old man, with a history of hypertension and left supraclavicular fossa arteriovenous malformation with multiple previous uncomplicated vessel embolisation procedures, presented with acute spastic quadriparesis and urinary retention following upper limb angiography and embolisation. There was no evidence of preceding infection or neurological disease prior to the event. Cerebrospinal fluid analysis was unremarkable. MRI of the cervical spine with a 1.5 Tesla magnet performed 13 hours from symptom onset revealed bilateral paramedian intramedullary T2-weighted signal change without gadolinium enhancement limited to the grey matter with corresponding diffusion restriction extending from C5–6 down to the mid-T1. The diagnosis of cervical spinal cord infarction (SCI) was made and the patient was given regular aspirin and atorvastatin. On follow-up at 3 months, there was modest improvement with respect to his quadriparesis and was walking unaided. An extensive literature review on the role of MRI in SCI is discussed.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Clinical Neuroscience
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • de Seze J.
        • Stojkovic T.
        • Breteau G.
        • et al.
        Acute myelopathies: clinical, laboratory and outcome profiles in 79 cases.
        Brain. 2001; 124: 1509-1521
        • Nedeltchev K.
        • Loher T.J.
        • Stepper F.
        • et al.
        Long-term outcome of acute spinal cord ischemia syndrome.
        Stroke. 2004; 35: 560-565
        • Robertson C.E.
        • Brown Jr., R.D.
        • Wijdicks E.F.
        • et al.
        Recovery after spinal cord infarcts: long-term outcome in 115 patients.
        Neurology. 2012; 78: 114-121
        • Stepper F.
        • Lovblad K.O.
        Anterior spinal artery stroke demonstrated by echo-planar DWI.
        Eur Radiol. 2001; 11: 2607-2610
        • Dublin A.B.
        • Latchaw R.E.
        • Herrera D.A.
        • et al.
        Delayed complication after embolotherapy of a vertebral arteriovenous fistula: spinal cord ischemia.
        J Vasc Interv Radiol. 2010; 21: 392-393
        • Goetz C.G.
        Textbook of clinical neurology.
        3rd ed. Saunders Elsevier, Philadelphia2007
        • Cheshire W.P.
        • Santos C.C.
        • Massey E.W.
        • et al.
        Spinal cord infarction: etiology and outcome.
        Neurology. 1996; 47: 321-330
        • Duggal N.
        • Lach B.
        Selective vulnerability of the lumbosacral spinal cord after cardiac arrest and hypotension.
        Stroke. 2002; 33: 116-121
        • Yuh W.T.
        • Marsh 3rd, E.E.
        • Wang A.K.
        • et al.
        MR imaging of spinal cord and vertebral body infarction.
        AJNR Am J Neuroradiol. 1992; 13: 145-154
        • Hasegawa M.
        • Yamashita J.
        • Yamashima T.
        • et al.
        Spinal cord infarction associated with primary antiphospholipid syndrome in a young child. Case report.
        J Neurosurg. 1993; 79: 446-450
        • Mawad M.E.
        • Rivera V.
        • Crawford S.
        • et al.
        Spinal cord ischemia after resection of thoracoabdominal aortic aneurysms: MR findings in 24 patients.
        AJNR Am J Neuroradiol. 1990; 11: 987-991
        • Sagiuchi T.
        • Iida H.
        • Tachibana S.
        • et al.
        Case report: diffusion-weighted MRI in anterior spinal artery stroke of the cervical spinal cord.
        J Comput Assist Tomogr. 2003; 27: 410-414
        • Marcel C.
        • Kremer S.
        • Jeantroux J.
        • et al.
        Diffusion-weighted imaging in noncompressive myelopathies: a 33-patient prospective study.
        J Neurol. 2010; 257: 1438-1445
        • Weidauer S.
        • Nichtweiss M.
        • Lanfermann H.
        • et al.
        Spinal cord infarction: MR imaging and clinical features in 16 cases.
        Neuroradiology. 2002; 44: 851-857
        • Fujikawa A.
        • Tsuchiya K.
        • Takeuchi S.
        • et al.
        Diffusion-weighted MR imaging in acute spinal cord ischemia.
        Eur Radiol. 2004; 14: 2076-2078
        • Loher T.J.
        • Bassetti C.L.
        • Lovblad K.O.
        • et al.
        Diffusion-weighted MRI in acute spinal cord ischaemia.
        Neuroradiology. 2003; 45: 557-561
        • Kuker W.
        • Weller M.
        • Klose U.
        • et al.
        Diffusion-weighted MRI of spinal cord infarction–high resolution imaging and time course of diffusion abnormality.
        J Neurol. 2004; 251: 818-824
        • Fujikawa A.
        • Tsuchiya K.
        • Koppera P.
        • et al.
        Case report: spinal cord infarction demonstrated on diffusion-weighted MR imaging with a single-shot fast spin-echo sequence.
        J Comput Assist Tomogr. 2003; 27: 415-419