Neurological Surgery No Shinkei Geka Volume 33, Issue 5 (May 2005)

A Case of Subacute Combined Degeneration of the Spinal Cord Diagnosed by Characteristic Findings of Magnetic Resonance Imaging : Case Report and Review of 22 Cases Akitsugu MORISHITA 1 , Hiroshi TOMITA 2 , Yosiyuki TAKAISHI 2 , Masamitsu NISHIHARA 2 , Eiji KOHMURA 1 1Department of Neurosurgery,Kobe University Graduate School of Medicine 2Department of Neurosurgery,Shinsuma Hospital Keyword: posterior column , subacute combined degeneration , vitamin B12 deficiency , magnetic resonance imaging pp.489-495
Published Date 2005/5/1
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Subacute combined degeneration (SCD) is a rare cause of demyelination of the dorsal and lateral columns of the spinal cord,and is a neurogenic complication due to vitamin B12 deficiency. This report concerns a patient with progressive sensory disturbance,but no abnormal neurological findings. A 73-year-old man with gastrectomy presented with a 6-month history of gradually worsening tingling in both hands. Magnetic resonance imaging (MRI) of the cervical spine clearly showed symmetrical high-signal areas on T2WI involving the posterior columns of the cervical cord from C2 through C6. A diagnosis of SCD of the spinal cord was considered and confirmed by laboratory findings. The patient was treated with vitamin B12 supplements and showed gradual improvement in his clinical symptoms. Repeat MRI of the cervical spine after 3 months indicated a slight decrease in the area of the abnormal signal. Among all the possible causes of myelopathy,SCD of the spinal cord,involving neurological complications due to vitamin B12 deficiency,is one of the less often encountered diseases. Nevertheless,SCD should be considered in the differential diagnosis of all spinal cord,peripheral nerve,and neuropsychiatric disorders.

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Neurological Surgery 脳神経外科
33巻5号 (2005年5月)
電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院