Name of the Patient : Abc Xyz Mandalmn / M / 14 yrs.
Referred by : Dr. Abc Xyzzzare.
Examination : M.R.I. of the Cervical Spine.
CLINICAL PROFILE :
H/O high grade fever on 00.00.0000 with weakness of BLE and bladder/bowel involvement since 00.00.0000.
M.R.I of the cervical spine was performed using the following parameters :
4 mm thick T1 Weighted and T2 Weighted sagittal images.
5 mm thick T1 Weighted and Fast Scan (T2 *) axial images.
There is an increase in the diameter of the cervical spinal cord over the C3 to C7 vertebral levels. There is an ill-defined, hyperintense signal on the T2 Weighted and Fast Scan (T2 *) images in the cervical spinal cord, centrally, extending over the C2 to C7 vertebral levels. This lesion appears iso to hypointense to normal cord on the T1 Weighted images.
The cervical vertebral bodies and the intervertebral discs show normal signal intensity. The joints of Luschka and the visualized pre and paravertebral soft tissues are unremarkable.
The atlanto-axial region is unremarkable.
Screening, T2 Weighted sagittal images of the dorsal spine reveals patchy increased signal, centrally, scattered in the dorsal spinal cord more so over the D11 to L1 vertebral levels.
Screening, T2 Weighted axial images of the brain reveals patchy increased signal intensity lesions in the medulla, right middle cerebellar peduncle, pons on the left, posterior capsular regions bilaterally, genu and splenium of the corpus callosum and diffuse signal alteration in the deep white matter in the fronto-parietal regions bilaterally.
Altered signal in the cervical and dorsal spinal cord and in the brain parenchyma as described is not specific for a single etiology.
A demyelinating etiology (acute disseminated encephalomyelitis is a likely possibility) should be considered.