case_images: PMC11177679_01
case_images: (A) MRI in case 1. Coronal brain FLAIR showed hyperintense signals along the corticospinal tracts from the posterior limb of the internal capsules, expanding bilaterally to the corona radiata (white arrow) without enhancement. Axial T2WI of C3 displayed hyperintensity involving the lateral and posterior columns bilaterally (red arrowhead and red arrow), which lasted throughout the spine. We termed this unique characteristic image 'Grasshopper sign' because these abnormalities looked like a grasshopper's face (spine) and antennae (brain). (B) MRI in case 2. Coronal brain FLAIR showed hyperintensity along the corticospinal tracts involving internal capsules (white arrow). Axial T2WI of T7 revealed hyperintensity involving lateral and posterior columns bilaterally (red arrowhead and red arrow). (C) MRI in case 3. Axial and coronal brain FLAIR showed hyperintensity along the corticospinal tracts (white arrow). Axial T2WI of C2 showed hyperintensity involving bilateral lateral columns and partially posterior columns (red arrowhead). (D) MRI in case 4. Coronal brain FLAIR and axial T2WI of C2 revealed a more apparent 'Grasshopper sign' compared with the other cases. C, cervical; FLAIR, fluid-attenuated inversion recovery; T, thoracic; T2WI, T2-weighted imaging.
case_images: bmjno-2024-000730f01.jpg
case_images: PMC11177679_04_bmjno-2024-000730f01.jpg
case_images: F1
case_images: Brain and cervical MRI in our hospital revealed a more apparent symmetrical longitudinal tract-specific hyperintensities in T2WI/FLAIR compared with cases 1-3 (figure 1D).
case_images: PMC11177679_02
case_images: (A) MRI in case 1. Coronal brain FLAIR showed hyperintense signals along the corticospinal tracts from the posterior limb of the internal capsules, expanding bilaterally to the corona radiata (white arrow) without enhancement. Axial T2WI of C3 displayed hyperintensity involving the lateral and posterior columns bilaterally (red arrowhead and red arrow), which lasted throughout the spine. We termed this unique characteristic image 'Grasshopper sign' because these abnormalities looked like a grasshopper's face (spine) and antennae (brain). (B) MRI in case 2. Coronal brain FLAIR showed hyperintensity along the corticospinal tracts involving internal capsules (white arrow). Axial T2WI of T7 revealed hyperintensity involving lateral and posterior columns bilaterally (red arrowhead and red arrow). (C) MRI in case 3. Axial and coronal brain FLAIR showed hyperintensity along the corticospinal tracts (white arrow). Axial T2WI of C2 showed hyperintensity involving bilateral lateral columns and partially posterior columns (red arrowhead). (D) MRI in case 4. Coronal brain FLAIR and axial T2WI of C2 revealed a more apparent 'Grasshopper sign' compared with the other cases. C, cervical; FLAIR, fluid-attenuated inversion recovery; T, thoracic; T2WI, T2-weighted imaging.
case_images: bmjno-2024-000730f01.jpg
case_images: PMC11177679_04_bmjno-2024-000730f01.jpg
case_images: F1
case_images: Brain and cervical MRI in our hospital revealed a more apparent symmetrical longitudinal tract-specific hyperintensities in T2WI/FLAIR compared with cases 1-3 (figure 1D).
case_images: PMC11177679_03
case_images: (A) MRI in case 1. Coronal brain FLAIR showed hyperintense signals along the corticospinal tracts from the posterior limb of the internal capsules, expanding bilaterally to the corona radiata (white arrow) without enhancement. Axial T2WI of C3 displayed hyperintensity involving the lateral and posterior columns bilaterally (red arrowhead and red arrow), which lasted throughout the spine. We termed this unique characteristic image 'Grasshopper sign' because these abnormalities looked like a grasshopper's face (spine) and antennae (brain). (B) MRI in case 2. Coronal brain FLAIR showed hyperintensity along the corticospinal tracts involving internal capsules (white arrow). Axial T2WI of T7 revealed hyperintensity involving lateral and posterior columns bilaterally (red arrowhead and red arrow). (C) MRI in case 3. Axial and coronal brain FLAIR showed hyperintensity along the corticospinal tracts (white arrow). Axial T2WI of C2 showed hyperintensity involving bilateral lateral columns and partially posterior columns (red arrowhead). (D) MRI in case 4. Coronal brain FLAIR and axial T2WI of C2 revealed a more apparent 'Grasshopper sign' compared with the other cases. C, cervical; FLAIR, fluid-attenuated inversion recovery; T, thoracic; T2WI, T2-weighted imaging.
case_images: bmjno-2024-000730f01.jpg
case_images: PMC11177679_04_bmjno-2024-000730f01.jpg
case_images: F1
case_images: Brain and cervical MRI in our hospital revealed a more apparent symmetrical longitudinal tract-specific hyperintensities in T2WI/FLAIR compared with cases 1-3 (figure 1D).
case_images: PMC11177679_04
case_images: (A) MRI in case 1. Coronal brain FLAIR showed hyperintense signals along the corticospinal tracts from the posterior limb of the internal capsules, expanding bilaterally to the corona radiata (white arrow) without enhancement. Axial T2WI of C3 displayed hyperintensity involving the lateral and posterior columns bilaterally (red arrowhead and red arrow), which lasted throughout the spine. We termed this unique characteristic image 'Grasshopper sign' because these abnormalities looked like a grasshopper's face (spine) and antennae (brain). (B) MRI in case 2. Coronal brain FLAIR showed hyperintensity along the corticospinal tracts involving internal capsules (white arrow). Axial T2WI of T7 revealed hyperintensity involving lateral and posterior columns bilaterally (red arrowhead and red arrow). (C) MRI in case 3. Axial and coronal brain FLAIR showed hyperintensity along the corticospinal tracts (white arrow). Axial T2WI of C2 showed hyperintensity involving bilateral lateral columns and partially posterior columns (red arrowhead). (D) MRI in case 4. Coronal brain FLAIR and axial T2WI of C2 revealed a more apparent 'Grasshopper sign' compared with the other cases. C, cervical; FLAIR, fluid-attenuated inversion recovery; T, thoracic; T2WI, T2-weighted imaging.
case_images: bmjno-2024-000730f01.jpg
case_images: PMC11177679_04_bmjno-2024-000730f01.jpg
case_images: F1
case_images: Brain and cervical MRI in our hospital revealed a more apparent symmetrical longitudinal tract-specific hyperintensities in T2WI/FLAIR compared with cases 1-3 (figure 1D).