PMC5423910_01
(A) Sagittal T2-weighted magnetic resonance imaging (MRI) of the cervicothoracic spinal cord on admission showed a hyperintense "pencil-like" lesion at the level of the anterior horn which extends from the level of the second cervical to second thoracic vertebral level (red arrowheads) and cord swelling in large parts of the affected area. (B,C) Follow-up T2-weighted MRI 9 weeks later revealed a less homogenous hyperintense filiform signal in the anterior region of the cervicothoracic cord and circumscribed medullar atrophy in the sagittal plane (red arrowheads). The axial MRI is at the C5 level and demonstrates bilateral hyperintensive signals involving the anterior horns of both sides (owl's eye appearance, red arrowheads).
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F1
Spinal cord MRI demonstrated a "pencil-like" T2 lesion expanding from C2 to T2 in the anterior part of the sagittal plane and swelling of the cervicothoracic cord (Figure 1A). Follow-up examination continued to demonstrate a cervicothoracic fusiform lesion in addition to focal atrophy and cavitation (Figures 1B,C).