PMC9845570_01
Spinal MR imaging (MRI) workup. (A) Mid-sagittal T2-weighted view from C0 to T5 showing linear hypersignal intensity within posterior columns prominently at the level of C5-C6 (white arrow). At the thoracic level, only faint signal intensity changes were suspected (dotted arrow at T2 level). (B) Axial transverse T2-weighted view at C5 level showing the posterior mid-sagittal focus of abnormal hypersignal intensity (arrow) reflecting elective tissue damage to the posterior columns. (C) Axial transverse T2-weighted view at T2 level showing decrease in size of tissue damage within posterior columns (middle arrow), but the appearance of abnormal hypersignal intensity within both crossed cortico-spinal tracts (lateral arrows), which were mostly outside slice location on mid-sagittal T2 view (1A).
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F1
Spinal cord magnetic resonance imaging (MRI) showed abnormal linear hyperintensities on the T2-weighted views within the postero-lateral and posterior columns from C4 to T1 mimicking metabolic deficiency (Figure 1).
Brain MRI workup. Three axial transverse FLAIR views from the top to bottom showing moderate and symmetrical hypersignal intensity of the corticospinal tract (arrows) at the levels of the following: (A) the corona radiata, (B) the posterior arm of the internal capsule, and (C) the thalamo-mesencephalic junction.
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F2
T2/FLAIR views (Figure 2). The diagnosis of degenerative or toxic myelopathy was suspected, and further investigations were performed.