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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2017; 75(07): 488
DOI: 10.1590/0004-282X20170068
IMAGES IN NEUROLOGY

Magnetic resonance findings in subacute combined degeneration

Achados na RM em degeneração combinada subaguda
Christiane Maria França Coimbra
1   Hospital Universitário de Brasília, Unidade de Diagnóstico por Imagem, Brasília DF, Brasil.
,
Samara Oliveira Dias
1   Hospital Universitário de Brasília, Unidade de Diagnóstico por Imagem, Brasília DF, Brasil.
,
Neysa Regattieri
1   Hospital Universitário de Brasília, Unidade de Diagnóstico por Imagem, Brasília DF, Brasil.
,
Flávio Luz Garcia Pires
1   Hospital Universitário de Brasília, Unidade de Diagnóstico por Imagem, Brasília DF, Brasil.
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A 47-year-old man presented with paresthesia of the arms, disorientation and ataxia. Past medical history included alcoholism, and cholecystectomy one week prior (nitrous oxide was administrated during anesthesia). Neuroimaging revealed bilateral symmetric high signal within the dorsal columns of the cervical cord, suggesting the diagnosis of subacute combined degeneration. On cross-section images, this appearance has been described as the “inverted V sign” ([Figure A], [B]). The laboratory test showed a low serum vitamin B12 level, confirming the diagnosis. Once the deficiency was corrected, the patient improved clinically and the spinal cord signal changes had subsided by the three-month follow-up ([Figure C], [D])[1],[2],[3].

Zoom Image
Figure Neuroimaging findings in subacute combined degeneration. Sagittal and axial MR spinal images on T2-weighted sequences demonstrate abnormal high signal within the dorsal columns of the cervical cord (A, B), and the complete resolution of signal abnormalities at a three-month follow-up (C, D).

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Conflict of interest:

There is no conflict of interest to declare.

  • References

  • 1 Sun HY, Lee JW, Park KS, Wi JY, Kang HS. Spine MR imaging features of subacute combined degeneration patients. Eur Spine J. 2014;23(5):1052-8. https://doi.org/10.1007/s00586-014-3191-4
  • 2 Hathout L, El-Saden S. Nitrous oxide-induced B12 deficiency myelopathy: perspectives on the clinical biochemistry of vitamin B12. J Neurol Sci. 2011;301(1-2):1-8. https://doi.org/10.1016/j.jns.2010.10.033
  • 3 Gupta PK, Gupta RK, Garg RK, Rai Y, Roy B, Pandey CM et al. DTI correlates of cognition in conventional MRI of normal-appearing brain in patients with clinical features of subacute combined degeneration and biochemically proven vitamin B(12) deficiency. AJNR Am J Neuroradiol. 2014;35(5):872-77. https://doi.org/10.3174/ajnr.A3785

Address for correspondence

Samara Oliveira Dias
Hospital Universitário de Brasília, Radiologia e Diagnóstico por Imagem; SGAN 605, Av. L2 Norte; 70840-90 Brasília DF
Brasil   

Publikationsverlauf

Eingereicht: 10. Oktober 2016

Angenommen: 14. März 2017

Artikel online veröffentlicht:
05. September 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Sun HY, Lee JW, Park KS, Wi JY, Kang HS. Spine MR imaging features of subacute combined degeneration patients. Eur Spine J. 2014;23(5):1052-8. https://doi.org/10.1007/s00586-014-3191-4
  • 2 Hathout L, El-Saden S. Nitrous oxide-induced B12 deficiency myelopathy: perspectives on the clinical biochemistry of vitamin B12. J Neurol Sci. 2011;301(1-2):1-8. https://doi.org/10.1016/j.jns.2010.10.033
  • 3 Gupta PK, Gupta RK, Garg RK, Rai Y, Roy B, Pandey CM et al. DTI correlates of cognition in conventional MRI of normal-appearing brain in patients with clinical features of subacute combined degeneration and biochemically proven vitamin B(12) deficiency. AJNR Am J Neuroradiol. 2014;35(5):872-77. https://doi.org/10.3174/ajnr.A3785

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Zoom Image
Figure Neuroimaging findings in subacute combined degeneration. Sagittal and axial MR spinal images on T2-weighted sequences demonstrate abnormal high signal within the dorsal columns of the cervical cord (A, B), and the complete resolution of signal abnormalities at a three-month follow-up (C, D).