SNAKE EYES |
LOCATION
|
SAGITTAL T2 |
POST CONTRAST |
Other features |
Typically thoracolumbar.
Long or Short: short segment
lesions commonest1.
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Single Lesion
|
Hyperintense signal (iso on T1)2
Pencil-like hyperintensity1 (especially with anterior spinal
artery infarction).
Linear Strip
Owl's eye appearance: anterior horns and
adjacent white matter bilaterally (ASA infarct)
Posterior columns or posterior paramedian
triangular hyperintensity (PSA infarct).
|
Enhancement in minority (diffuse/patchy)3, 4
|
- Diffusion restriction
- Vertebral body infarct with marrow
signal changes5
- Adjacent artery dissection.
- Visualization of the artery of Adamkiewicz
by MR angiography2
- Lateral and midline disc herniation6.
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From: Amoiridis G, Ameridou I, Mavridis M. Intervertebral disk and vertebral body infarction as a confirmatory sign of spinal cord ischemia. Neurology. 2004 Nov 9;63(9):1755. doi: 10.1212/01.wnl.0000142973.33952.68. PMID: 15534280.
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AXIAL T2
|
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 |
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From: Novy J, Carruzzo A, Maeder P, Bogousslavsky J. Spinal cord ischemia: clinical and imaging patterns, pathogenesis, and outcomes in 27 patients. Arch Neurol. 2006 Aug;63(8):1113-20. doi: 10.1001/archneur.63.8.1113. PMID: 16908737.
Note: Image orientation as per MRI convention, with anterior horn shown at top of the page
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References
1 Yadav N, Pendharkar H, Kulkarni GB. Spinal Cord Infarction: Clinical and Radiological Features. J Stroke Cerebrovasc Dis 2018; 27: 2810–21.
2 Vargas MI, Gariani J, Sztajzel R, et al. Spinal Cord Ischemia: Practical Imaging Tips, Pearls, and Pitfalls. Am J Neuroradiol 2015; 36: 825–30.
3 Flanagan EP. Autoimmune myelopathies, 1st edn. Elsevier B.V., 2016 DOI:10.1016/B978-0-444-63432-0.00019-0.
4 Yuh WTC, Marsh EE, Wang AK, et al. MR imaging of spinal cord and vertebral body infraction. Am J Neuroradiol 1992; 13: 145–54.
5 Amoiridis G, Ameridou I, Mavridis M. Intervertebral disk and vertebral body infarction as a confirmatory sign of spinal cord ischemia. Neurology 2004; 63: 1755.
6 Novy J, Carruzzo A, Maeder P, Bogousslavsky J. Spinal cord ischemia: clinical and imaging patterns, pathogenesis, and outcomes in 27 patients. Arch Neurol 2006; 63: 1113–20.