Role of Diffusion MRI in Diagnosis of Spinal Cord Infarction in Children

Abstract

Anterior spinal artery (ASA) infarction is a rare but well-described cause of flaccid paraparesis in adults, presenting with a high thoracic spinothalamic sensory level and preservation of dorsal column function. Careful sensory examination, demonstrating loss of spinothalamic modalities with preservation of dorsal column modalities, supports a clinical diagnosis of ASA infarction. Findings on conventional MRI of the spinal cord are often non-specific, and diffusion-weighted imaging (DWI) is not routinely performed. We describe four children with ASA infarction after minor trauma. DWI was performed in all cases and confirmed the clinical diagnosis.

Key words

spinal cord infarction - anterior spinal artery - diffusion-weighted imaging - magnetic resonance imaging - child - pediatric spinal cord

References

• 1 Bammer R, Fazekas F. Diffusion imaging of the human spinal cord and the vertebral column.  Top Magn Reson Imaging. 2003;  14 461
• 2 Clark CA, Werring DJ. Diffusion tensor imaging in spinal cord: methods and applications – a review.  NMR Biomed. 2002;  15 578
• 3 Fifi JT, Meyers PM, Lavine SD. et al .Complications of modern diagnostic cerebral angiography in an academic medical center. In: International Stroke Conference. New Orleans 2008
• 4 Loher TJ, Bassetti CL, Lovblad KO. et al . Diffusion-weighted MRI in acute spinal cord ischaemia.  Neuroradiology. 2003;  45 557
• 5 Mohr JP, Choi DW, Grotta JC. et al .Stroke: Pathophysiology, Diagnosis and Management. 4th edn. Churchill Livingstone 2004
• 6 Nance JR, Golomb MR. Ischemic spinal cord infarction in children without vertebral fracture.  Pediatr Neurol. 2007;  36 209
• 7 Salvador de la Barrera S, Barca-Buyo A, Montoto-Marques A. et al . Spinal cord infarction: prognosis and recovery in a series of 36 patients.  Spinal Cord. 2001;  39 520
• 8 Stepper F, Lovblad KO. Anterior spinal artery stroke demonstrated by echo-planar DWI.  Eur Radiol. 2001;  11 2607
• 9 Thurnher MM, Bammer R. Diffusion-weighted MR imaging (DWI) in spinal cord ischemia.  Neuroradiology. 2006;  48 795
• 10 Tosi L, Rigoli G, Beltramello A. Fibrocartilaginous embolism of the spinal cord: a clinical and pathogenetic reconsideration.  J Neurol Neurosurg Psychiatry. 1996;  60 55

Correspondence