Subacute Combined Degeneration of the Cord: Putnam-Dana Syndrome

Abstract

The association of anaemia and gastro-intestinal abnormalities with disorders of the brain, spinal cord, and peripheral nerves has been recognized since the mid 19th century. In early reports interpretable as subacute combined degeneration, anaemia was overlooked, and conversely in Addison’s and other early reports of pernicious anaemia, cord and nerve changes were not recorded. This paper shows that Lichtheim first combined the two observations, and illustrates the excellent descriptions in 1890 of James Putnam and Charles Dana. The most complete early account was that of Russell, Batten and Collier in 1900.

Three-point sign in subacute combined degeneration of the spinal cord

“…Clinically, SCD manifests as paresthesia, ataxia, spastic paraplegia, and peripheral neuropathy, frequently accompanied by anemia. [ 1 ] On magnetic resonance imaging (MRI), only 11.1% to 36.7% patients have shown remarkable abnormalities. [ 2 ] The previously identified distinctive characteristics included an “inverted V sign,” a “pair of binoculars sign,” and a “dot sign.” [ 3 – 6 ] Herein, we report a novel MRI pattern, the 3-point sign, in a case of SCD.…”