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Logo of neurologyNeurologyAmerican Academy of Neurology
 
Neurology. 2012 November 27; 79(22): 2217.
PMCID: PMC3570817

7T MRI of spinal cord injury

Abstract

A man with 25 years of mild left neck, arm, and leg paresthesias had initial MRI in 1996 identifying a left C3-4 dorsal horn cavernous hemangioma. In 1997, hemorrhage (C3-7) and resection induced left arm > leg proprioceptive loss and clumsiness. Three months after surgical resection, left upper-body pain recurred; 2 years later, disabling colocalizing itch recurred.1 In 2012, ultra-high-resolution 7T MRI (figure) localized hemosiderin to specific dorsal horn laminae and detected rostral (C1-3) hypersignal invisible on conventional MRIs, most likely representing wallerian degeneration.2 These new imaging findings demonstrate the benefit of high-field spinal cord MRI and generate the hypothesis that his late-onset central itch might be related to delayed white matter degeneration.

A man with 25 years of mild left neck, arm, and leg paresthesias had initial MRI in 1996 identifying a left C3-4 dorsal horn cavernous hemangioma. In 1997, hemorrhage (C3-7) and resection induced left arm > leg proprioceptive loss and clumsiness. Three months after surgical resection, left upper-body pain recurred; 2 years later, disabling colocalizing itch recurred.1 In 2012, ultra-high-resolution 7T MRI (figure) localized hemosiderin to specific dorsal horn laminae and detected rostral (C1-3) hypersignal invisible on conventional MRIs, most likely representing wallerian degeneration.2 These new imaging findings demonstrate the benefit of high-field spinal cord MRI and generate the hypothesis that his late-onset central itch might be related to delayed white matter degeneration.

Figure
7T MRI

Footnotes

Contributed by

Author contributions: Dr. Cohen-Adad: study concept and design, acquisition of data. Dr. Zhao: acquisition of data. Dr. Wald: study supervision. Dr. Oaklander: study concept and design.

Study funding: NIH-P41RR14075, NIH-K24NS59892, NIH-P41RR14075, NMSS-FG1892A1/1.

The authors report no disclosures relevant to the manuscript. Go to Neurology.org for full disclosures.

References

1. Dey DD, Landrum O, Oaklander AL. Central neuropathic itch from spinal-cord cavernous hemangioma: a human case, a possible animal model, and hypotheses about pathogenesis. Pain 2005;113:233–237 [PubMed]
2. Becerra JL, Puckett WR, Hiester ED, et al. MR-pathologic comparisons of wallerian degeneration in spinal cord injury. AJNR Am J Neuroradiol 1995;16:125–133 [PubMed]

Articles from Neurology are provided here courtesy of American Academy of Neurology