MRI-pathological correlations in acute traumatic central cord syndrome: case report.
Ante- and post-mortem MRI and detailed pathological examination were performed in a patient with a typical acute traumatic central cord syndrome (ATCCS) after a minor hyperextension injury to the neck who died 60 h later from heart failure. T2-weighted MRI showed a central hyperintense area at C3-4. There were disc protrusions, but no vertebral fracture or displacement. Histopathology disclosed severe axonal swelling and oedema in the dorsolateral fasciculi and, to a lesser degree, in the dorsal columns. In addition, an area of recent necrosis was found in the right anterior horn at C4-5. These findings suggest that the pathological hallmark of typical ATCCS is mechanical axonal disruption at a segmental level, but that more severe trauma may be accompanied by tissue destruction.
Martin
D
D
Department of Neurosurgery, University of Liège, Belgium.
Schoenen
J
J
Lenelle
J
J
Reznik
M
M
Moonen
G
G
D001369:Axons / Q000648:ultrastructure; D002574:Cervical Vertebrae / Q000293:injuries* / Q000473:pathology; D006333:Heart Failure / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D009460:Neurologic Examination; D013116:Spinal Cord / Q000473:pathology; D013117:Spinal Cord Compression / Q000175:diagnosis* / Q000473:pathology; D014911:Whiplash Injuries / Q000175:diagnosis* / Q000473:pathology