Short case publication... version 2.5 | Edited by professor Yasser Metwally | November 2008




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Figure 1. Precontrast MR T1 images showing a huge right sided intraventricular /parenchymal cyst associated with
agenesis ...
Figure 3.  A case of spinal multiple sclerosis. MRI T2 images showing pencil shaped multiple sclerosis plaques
that occupy...
Addendum

   A new version of short case is uploaded in my web site every week (every Saturday and remains available till ...
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Short case...Spinal multiple sclerosis

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Short case...Spinal multiple sclerosis

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Short case...Spinal multiple sclerosis

  1. 1. Short case publication... version 2.5 | Edited by professor Yasser Metwally | November 2008 Short case Edited by Professor Yasser Metwally Professor of neurology Ain Shams university school of medicine Cairo, Egypt Visit my web site at: http://yassermetwally.com A 30 years old female patient known to be suffering from relapsing, remitting multiple sclerosis presented clinically with paraplegia with a sensory level. DIAGNOSIS: SPINAL MULTIPLE SCLEROSIS
  2. 2. Figure 1. Precontrast MR T1 images showing a huge right sided intraventricular /parenchymal cyst associated with agenesis of the septum pellucidum. The corpus callosum is markedly hypoplastic and deficient. The cerebral cortex is lissencephalic. Notice the right sided hemimegalencephaly and the subependymal nodular heterotopia. Subcortical band heterotopia can also be appreciated. Figure 2.  A case of spinal multiple sclerosis. MRI T2 images showing pencil shaped multiple sclerosis plaques that occupy 2-3 spinal segments The plaques are orientated along the longitudinal axis of the spinal cord on sagittal sections. The plaques are short (less than two spinal segments), pencil shaped, multiple and well demarcated. No evidence of spinal cord atrophy. The spinal cord parenchyma is asymmetrically involved. Diffuse abnormalities seen as poorly demarcated areas of increased signal intensity on MRI T2 images are also seen in this study. Diffuse abnormalities are more common in primary progressive MS and secondary progressive MS.
  3. 3. Figure 3.  A case of spinal multiple sclerosis. MRI T2 images showing pencil shaped multiple sclerosis plaques that occupy 2-3 spinal segments The plaques are orientated along the longitudinal axis of the spinal cord on sagittal sections. The plaques are short (less than two spinal segments), pencil shaped, multiple and well demarcated. No evidence of spinal cord atrophy. The spinal cord parenchyma is asymmetrically involved. Diffuse abnormalities seen as poorly demarcated areas of increased signal intensity on MRI T2 images are also seen in this study. Diffuse abnormalities are more common in primary progressive MS and secondary progressive MS. Figure 4. MRI T2 images in a patient with spinal multiple sclerosis showing a peripherally located hyperintense MS plaque. The plaque is surrounded by a hypointense incomplete ring that could be due to the presence of paramagnetic free radicals within the phagocytosing macrophages which are heterogeneously distributed in the periphery of the inflammatory lesion, paramagnetic free radicals induce T2 hypointensity. Spinal cord demyelinating plaques present as well circumscribed foci of increased T2 signal that asymmetrically involve the spinal cord parenchyma. They are characteristically peripherally located, are less than two vertebral segments in length, and occupy less than half the cross-sectional area of the cord. On axial MR images, the lesions located in the lateral segments have a wedge shape with the basis at the cord surface or a round shape if there is no contact with the cord surface. The distribution of MS lesions in the spinal cord closely corresponds to venous drainage areas.
  4. 4. Addendum A new version of short case is uploaded in my web site every week (every Saturday and remains available till Friday.) To download the current version follow the link quot;http://pdf.yassermetwally.com/short.pdfquot;. You can download the long case version of this short case during the same week from: http://pdf.yassermetwally.com/case.pdf or visit web site: http://pdf.yassermetwally.com To download the software version of the publication (crow.exe) follow the link: http://neurology.yassermetwally.com/crow.zip At the end of each year, all the publications are compiled on a single CD-ROM, please contact the author to know more details. Screen resolution is better set at 1024*768 pixel screen area for optimum display For an archive of the previously reported cases go to www.yassermetwally.net, then under pages in the right panel, scroll down and click on the text entry quot;downloadable short cases in PDF formatquot; Also to view a list of the previously published case records follow the following link (http://wordpress.com/tag/case- record/) or click on it if it appears as a link in your PDF reader References 1. Metwally, MYM: Textbook of neurimaging, A CD-ROM publication, (Metwally, MYM editor) WEB-CD agency for electronic publishing, version 9.4a October 2008

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