case_images: PMC9845570_01
case_images: Spinal MR imaging (MRI) workup. (A) Mid-sagittal T2-weighted view from C0 to T5 showing linear hypersignal intensity within posterior columns prominently at the level of C5-C6 (white arrow). At the thoracic level, only faint signal intensity changes were suspected (dotted arrow at T2 level). (B) Axial transverse T2-weighted view at C5 level showing the posterior mid-sagittal focus of abnormal hypersignal intensity (arrow) reflecting elective tissue damage to the posterior columns. (C) Axial transverse T2-weighted view at T2 level showing decrease in size of tissue damage within posterior columns (middle arrow), but the appearance of abnormal hypersignal intensity within both crossed cortico-spinal tracts (lateral arrows), which were mostly outside slice location on mid-sagittal T2 view (1A).
case_images: fneur-13-1063803-g0001.jpg
case_images: PMC9845570_01_fneur-13-1063803-g0001.jpg
case_images: F1
case_images: Spinal cord magnetic resonance imaging (MRI) showed abnormal linear hyperintensities on the T2-weighted views within the postero-lateral and posterior columns from C4 to T1 mimicking metabolic deficiency (Figure 1).
case_images: Brain MRI workup. Three axial transverse FLAIR views from the top to bottom showing moderate and symmetrical hypersignal intensity of the corticospinal tract (arrows) at the levels of the following: (A) the corona radiata, (B) the posterior arm of the internal capsule, and (C) the thalamo-mesencephalic junction.
case_images: fneur-13-1063803-g0002.jpg
case_images: PMC9845570_01_fneur-13-1063803-g0002.jpg
case_images: F2
case_images: T2/FLAIR views (Figure 2). The diagnosis of degenerative or toxic myelopathy was suspected, and further investigations were performed.