#Myelopathic how to

Use high resolution transverse images to detect the location within the cord.

Location of the involvement on transverse images?.

Partial involvement is typically seen in MS.Ĭomplete involvement includes both halves of the cord and is typically seen in TM and NMO.

How much of the cord is involved on tranverse images?.

In other diseases like Transverse Myelitis, NMO and ischemia there is usually a long segment involved. In MS there is typically a short segment involved, i.e. Whenever there is an abnormality in the spinal cord, we need a systematic approach to analyse the findings.Ĭlinical findings can be helpful but can be quite similar in most spinal cord disorders. Infection rarely involves the spinal cord. So always look for abnormal vessels around the cord. Metastases to the cord are very uncommon.Īcute ischemia is typically seen as a complication of aortic aneurysm surgery or catheterisation.Ĭord ischemia due to venous hypertension or arterial steal can be seen in vascular malformations like AV-fistula. The other common spinal cord tumors like ependymoma and hemangioblastoma do not cause differential diagnostic problems, because in most cases they just look like a tumor. The major differential of demyelinating diseases is an astrocytoma, especially if there is swelling and some enhancement of the cord and when the symptoms are more slowly progressive. If both halves of the cord are involved than think of Transverse Myelitis (TM) which is not a specific diagnosis, but merely a reaction of the cord to various autoimmune and infectious stimuli. If the patient has myelopathy and optic neuritis then also think of the possibility of Neuromyelitis Optica (NMO) and do the NMO-IgG test.

#Myelopathic how to

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