Skip to main content
Top
Published in: Journal of Medical Case Reports 1/2011

Open Access 01-12-2011 | Case report

Magnetic resonance imaging findings within the posterior and lateral columns of the spinal cord extended from the medulla oblongata to the thoracic spine in a woman with subacute combined degeneration without hematologic disorders: a case report and review of the literature

Authors: Samira Rabhi, Mustapha Maaroufi, Hajar Khibri, Faouzy Belahsen, Siham Tizniti, Rhizlane Berrady, Wafaa Bono

Published in: Journal of Medical Case Reports | Issue 1/2011

Login to get access

Abstract

Introduction

Subacute combined degeneration of the spinal cord is a rare cause of demyelination of the dorsal and lateral columns of the spinal cord and is a neurological complication of vitamin B12 deficiency. Subacute combined degeneration without anemia or macrocytosis is rare.

Case presentation

We present a case of cobalamin deficiency in a 29-year-old Moroccan woman who presented with subacute combined degeneration without evidence of anemia or macrocytosis. Magnetic resonance imaging of the spinal cord demonstrated abnormal hyperintense signal changes on T2-weighted imaging of the posterior and lateral columns from the medulla oblongata to the thoracic spine. A diagnosis of subacute combined degeneration of the spinal cord was considered and confirmed by low serum cobalamin. The patient was treated with vitamin B12 supplements and showed improvement in her clinical symptoms.

Conclusion

Physicians should diagnose subacute combined degeneration in patients early by having a high index of suspicion and using diagnostic tools such as magnetic resonance imaging.
Appendix
Available only for authorised users
Literature
1.
go back to reference Lee GR: Pernicious anemia and other causes of vitamin B12 (cobalamin) deficiency. Wintrobe's Clinical Hematology. Edited by: Lee GR, Foerster J, Lukens J, Paraskevas F, Greer JP, Rodgers GM. 1999, Baltimore: Lippincott Williams & Wilkins, 941-964. 10 Lee GR: Pernicious anemia and other causes of vitamin B12 (cobalamin) deficiency. Wintrobe's Clinical Hematology. Edited by: Lee GR, Foerster J, Lukens J, Paraskevas F, Greer JP, Rodgers GM. 1999, Baltimore: Lippincott Williams & Wilkins, 941-964. 10
2.
go back to reference Lindenbaum J, Healton EB, Savage DG, Brust JC, Garrett TJ, Podell ER, Marcell PD, Stabler SP, Allen RH: Neuropsychiatric disorders caused by cobalamin deficiency in the absence of anemia or macrocytosis. N Engl J Med. 1988, 318: 1720-1728. 10.1056/NEJM198806303182604.CrossRefPubMed Lindenbaum J, Healton EB, Savage DG, Brust JC, Garrett TJ, Podell ER, Marcell PD, Stabler SP, Allen RH: Neuropsychiatric disorders caused by cobalamin deficiency in the absence of anemia or macrocytosis. N Engl J Med. 1988, 318: 1720-1728. 10.1056/NEJM198806303182604.CrossRefPubMed
3.
go back to reference Karantanas AH, Markonis A, Bisbiyiannis G: Subacute combined degeneration of the spinal cord with involvement of the anterior columns: a new MRI finding. Neuroradiology. 2000, 42: 115-117. 10.1007/s002340050027.CrossRefPubMed Karantanas AH, Markonis A, Bisbiyiannis G: Subacute combined degeneration of the spinal cord with involvement of the anterior columns: a new MRI finding. Neuroradiology. 2000, 42: 115-117. 10.1007/s002340050027.CrossRefPubMed
4.
go back to reference Scalabrino G, Carpo M, Bamonti F, Pizzinelli S, D'Avino C, Bresolin N, Meucci G, Martinelli V, Comi GC, Peracchi M: High tumor necrosis factor-α levels in cerebrospinal fluid of cobalamin-deficient patients. Ann Neurol. 2004, 56: 886-890. 10.1002/ana.20325.CrossRefPubMed Scalabrino G, Carpo M, Bamonti F, Pizzinelli S, D'Avino C, Bresolin N, Meucci G, Martinelli V, Comi GC, Peracchi M: High tumor necrosis factor-α levels in cerebrospinal fluid of cobalamin-deficient patients. Ann Neurol. 2004, 56: 886-890. 10.1002/ana.20325.CrossRefPubMed
5.
go back to reference Timms SR, Curé JK, Kurent JE: Subacute combined degeneration of the spinal cord: MR findings. AJNR Am J Neuroradiol. 1993, 14: 1224-1227.PubMed Timms SR, Curé JK, Kurent JE: Subacute combined degeneration of the spinal cord: MR findings. AJNR Am J Neuroradiol. 1993, 14: 1224-1227.PubMed
6.
go back to reference Lee WJ, Hsu HY, Wang PY: Reversible myelopathy on magnetic resonance imaging due to cobalamin deficiency. J Chin Med Assoc. 2008, 71: 368-372. 10.1016/S1726-4901(08)70142-4.CrossRefPubMed Lee WJ, Hsu HY, Wang PY: Reversible myelopathy on magnetic resonance imaging due to cobalamin deficiency. J Chin Med Assoc. 2008, 71: 368-372. 10.1016/S1726-4901(08)70142-4.CrossRefPubMed
7.
go back to reference Bou-Haidar P, Peduto AJ, Karunaratne N: Differential diagnosis of T2 hyperintense spinal cord lesions: part B. J Med Imaging Radiat Oncol. 2009, 53: 152-159. 10.1111/j.1754-9485.2009.02067.x.CrossRefPubMed Bou-Haidar P, Peduto AJ, Karunaratne N: Differential diagnosis of T2 hyperintense spinal cord lesions: part B. J Med Imaging Radiat Oncol. 2009, 53: 152-159. 10.1111/j.1754-9485.2009.02067.x.CrossRefPubMed
8.
go back to reference Yamada K, Shrier DA, Tanaka H, Numaguchi Y: A case of subacute combined degeneration: MRI findings. Neuroradiology. 1998, 40: 398-400. 10.1007/s002340050610.CrossRefPubMed Yamada K, Shrier DA, Tanaka H, Numaguchi Y: A case of subacute combined degeneration: MRI findings. Neuroradiology. 1998, 40: 398-400. 10.1007/s002340050610.CrossRefPubMed
9.
go back to reference Fritschi J, Sturzenegger M: Spinal MRI supporting myelopathic origin of early symptoms in unsuspected cobalamin deficiency. Eur Neurol. 2003, 49: 146-150. 10.1159/000069087.CrossRefPubMed Fritschi J, Sturzenegger M: Spinal MRI supporting myelopathic origin of early symptoms in unsuspected cobalamin deficiency. Eur Neurol. 2003, 49: 146-150. 10.1159/000069087.CrossRefPubMed
10.
go back to reference Katsaros VK, Glocker FX, Hemmer B, Schumacher M: MRI of spinal cord and brain lesions in subacute combined degeneration. Neuroradiology. 1998, 40: 716-719. 10.1007/s002340050670.CrossRefPubMed Katsaros VK, Glocker FX, Hemmer B, Schumacher M: MRI of spinal cord and brain lesions in subacute combined degeneration. Neuroradiology. 1998, 40: 716-719. 10.1007/s002340050670.CrossRefPubMed
Metadata
Title
Magnetic resonance imaging findings within the posterior and lateral columns of the spinal cord extended from the medulla oblongata to the thoracic spine in a woman with subacute combined degeneration without hematologic disorders: a case report and review of the literature
Authors
Samira Rabhi
Mustapha Maaroufi
Hajar Khibri
Faouzy Belahsen
Siham Tizniti
Rhizlane Berrady
Wafaa Bono
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2011
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/1752-1947-5-166

Other articles of this Issue 1/2011

Journal of Medical Case Reports 1/2011 Go to the issue