“Snake eye” and “pencil-like” signs together with diaphragmatic paralysis in a patient with anterior spinal cord ischemia

Tébar, M.J. Martínez; Román, A. Baeza; Olmos, G. Julia Mejia

doi:10.1016/j.medine.2019.06.004

Cited by 3 publications

(1 citation statement)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The main pathological changes which can result in this appearance are cystic necrosis of the central gray matter of the ventrolateral column of the spinal cord and loss of neurons in the anterior horn of the spinal cord[ 29 ]. It is usually related to lower motor neuron syndrome, such as Hirayama disease[ 30 , 31 ], spinal muscular atrophy syndrome[ 32 ], cervical spondylotic myelopathy[ 33 ], amyotrophic lateral sclerosis[ 34 ], and anterior spinal artery ischemia[ 35 - 37 ], Detailed identification is shown in Table 2 [ 34 , 38 - 41 ]. There is a watershed area between the sulcus commissural artery and the coronary artery ring sent by the anterior spinal artery.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous conus infarction with "snake-eye appearance" on magnetic resonance imaging: A case report and literature review

Zhang¹,

Xu²,

Wang³

et al. 2023

World J Clin Cases

View full text Add to dashboard Cite

BACKGROUND Infarction of the conus medullaris is a rare form of spinal cord infarction. The first symptom is usually acute non-characteristic lumbar pain, followed by lower limb pain, saddle numbness, fecal incontinence, and sexual dysfunction. Spontaneous conus infarction with "snake-eye appearance" on magnetic resonance imaging has rarely been reported. CASE SUMMARY We report a 79-year-old male patient with spontaneous conus infarction who had acute lower extremity pain and dysuria as the first symptoms. He did not have any recent history of aortic surgery and trauma. Magnetic resonance imaging revealed a rare "snake-eye appearance." In addition, we reviewed the literature on 23 similar cases and summarized the clinical features and magnetic resonance manifestations of common diseases related to the "snake-eye sign" to explore the etiology, imaging findings, and prognosis of spontaneous conus infarction. CONCLUSION We conclude that acute onset of conus medullaris syndrome combined with "snake-eye appearance" should be strongly suspected as conus medullaris infarction caused by anterior spinal artery ischemia. This special imaging manifestation is helpful in the early diagnosis and treatment of conus infarction.

show abstract