Acute hemorrhagic leukoencephalitis with severe brainstem and spinal cord involvement: MRI features with neuropathological confirmation

The neurological complications of coronavirus disease 2019 (SARS-CoV-2, COVID-19) have so far included a range of para- and post-infectious neuroinflammatory syndromes inclusive of all components of the neuraxis and peripheral neuromuscular system. In comparison to the para-infectious manifestations of anosmia, ageusia, encephalopathy, and encephalitis, cases of post-infectious ADEM have rarely been reported and have most commonly affected the supratentorial component with or without spinal cord involvement. In this report, we describe a case of isolated involvement of the cervicothoracic spinal cord and medulla, occurring in association with microhemorrhages and hemosiderin deposition in the medulla, that presented fulminantly and required aggressive immunotherapy to control the inflammatory attack. We compare and contrast this case against prior reports of acute hemorrhagic leukoencephalitis (Weston Hurst syndrome) and review the atypical features of neuroinflammation reported to occur following COVID-19 infection.

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Frequency of Spinal Cord Involvement and Autoantibody Status in a Large Cohort of Children Presenting with a First Acute Demyelinating Syndrome

10.1055/s-0039-1698200 ◽

2019 ◽

Author(s):

Ines El Naggar ◽

Eva-Maria Wendel ◽

Christian Lechner ◽

Kathrin Schanda ◽

Michael Karenfort ◽

...

Keyword(s):

Spinal Cord ◽

Large Cohort ◽

Spinal Cord Involvement ◽

Autoantibody Status

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Faculty Opinions recommendation of Spinal cord involvement in multiple sclerosis and neuromyelitis optica spectrum disorders.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.734959278.793556675 ◽

2019 ◽

Author(s):

Mario Manto ◽

Lionel Paternoster

Keyword(s):

Multiple Sclerosis ◽

Spinal Cord ◽

Neuromyelitis Optica ◽

Neuromyelitis Optica Spectrum Disorders ◽

Spinal Cord Involvement ◽

Spectrum Disorders

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Spinal cord involvement and paroxysmal events in “Infantile Onset Transient Hypomyelination” due to TMEM63A mutation

Journal of Human Genetics ◽

10.1038/s10038-021-00921-1 ◽

2021 ◽

Author(s):

Davide Tonduti ◽

Eleonora Mura ◽

Silvia Masnada ◽

Enrico Bertini ◽

Chiara Aiello ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Involvement

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CTNI-03. IMAGING FEATURES OF LEPTOMENINGEAL METASTASES OF NON-SMALL CELL LUNG CANCER: A SINGLE-CENTER REAL-WORLD STUDY

Neuro-Oncology ◽

10.1093/neuonc/noaa215.170 ◽

2020 ◽

Vol 22 (Supplement_2) ◽

pp. ii41-ii41

Author(s):

Junjie Zhen ◽

Lei Wen ◽

Shaoqun Li ◽

Mingyao Lai ◽

Changguo Shan ◽

...

Keyword(s):

Spinal Cord ◽

Type A ◽

Brain Parenchyma ◽

Imaging Features ◽

Type B ◽

Type D ◽

Mri Examination ◽

Mri Features ◽

Brain And Spinal Cord ◽

The Brain

Abstract BACKGROUND According to EANO-ESMO clinical practice guidelines, the MRI findings of LM are divided into 4 types, namely linear enhancement (type A), nodular enhancement (type B), linear combined with nodular enhancement (type C), and sign of hydrocephalus (type D). METHODS The MRI features of brain and spinal cord in patients diagnosed with NSCLC-LM in Guangdong Sanjiu Brain Hospital from 2010 until 2019 were investigated, and then were classified into 4 types. The imaging features were analyzed. RESULTS A total of 80 patients were enrolled in the study. The median age of the patients was 53.5 years old, and the median time from the initial diagnosis to the confirmed diagnosis of LM was 11.6 months. The results of enhanced MRI examination of the brain in 79 cases showed that the number of cases with enhancements of type A, B, C and D were 50 (63.3%), 0, 26 (32.9%) and 3 (3.8%), respectively, and that LM with metastases to the brain parenchyma was found in 42 cases (53.2%). The results of enhanced MRI examination of spinal cord in 59 cases showed that there were only enhancements of type A and C in 40 cases (67.8%) and 3 cases (5.0%), and no enhancement sign in the other 16 cases (27.2%). CONCLUSION MRI examination of brain and spinal cord will improve the detection rate of LM. The MRI features of NSCLC-LM in real world are mainly characterized by the linear enhancements of brain and spinal cord, followed by linear combined with nodular enhancement. The enhancements of type B and type D are rare in clinic. Almost half of the patients have LM and metastases to the brain parenchyma. Therefore, the differentiation of tumor metastases is needed to be paid attention to for the early diagnosis and the formulation of reasonable treatment plans.

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Knee pain exacerbated by recumbency: an unusual manifestation of spinal cord involvement by diffuse histiocytic lymphoma

Arthritis & Rheumatism ◽

10.1002/art.1780270315 ◽

1984 ◽

Vol 27 (3) ◽

pp. 341-343 ◽

Cited By ~ 2

Author(s):

Wallace C. Christy ◽

Donald L. Powell

Keyword(s):

Spinal Cord ◽

Knee Pain ◽

Unusual Manifestation ◽

Spinal Cord Involvement ◽

Histiocytic Lymphoma ◽

Diffuse Histiocytic Lymphoma

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Spinal cord involvement in posterior reversible encephalopathy syndrome

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp.2008.154781 ◽

2008 ◽

Vol 80 (1) ◽

pp. 35-35 ◽

Cited By ~ 9

Author(s):

B Lapuyade ◽

I Sibon ◽

S Jeanin ◽

V Dousset

Keyword(s):

Spinal Cord ◽

Posterior Reversible Encephalopathy Syndrome ◽

Posterior Reversible Encephalopathy ◽

Spinal Cord Involvement ◽

Reversible Encephalopathy

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Spontaneous Spinal Epidural Haematomas and the Prognostic Implications of Interval to Surgical Decompression: A Report of Two Cases

Journal of Orthopaedic Surgery ◽

10.1177/230949900901700220 ◽

2009 ◽

Vol 17 (2) ◽

pp. 216-219 ◽

Cited By ~ 7

Author(s):

Colin Yi-Loong Woon ◽

Benedict Chan-Wearn Peng ◽

John Li-Tat Chen

Keyword(s):

Spinal Cord ◽

Spinal Cord Compression ◽

Lower Limb ◽

Cord Compression ◽

Surgical Decompression ◽

Neurological Recovery ◽

Uncontrolled Hypertension ◽

Motor Deficit ◽

Mri Features ◽

Spinal Epidural

Spontaneous spinal epidural haematomas (SSEHs) are rare causes of spinal cord compression. We present 2 cases of thoracic SSEHs with similar magnetic resonance imaging (MRI) features. Patient 1 was on long-term oral anticoagulants and patient 2 had uncontrolled hypertension. Patient 1 presented with a dense motor deficit, whereas patient 2 developed progressive lower limb weakness. Decompression laminectomy and haematoma evacuation was performed 51 hours later for patient 1 and 14 hours later for patient 2. Both had recovered their lower limb power, but neurological recovery was greater for patient 2. In patients with bleeding diatheses or uncontrolled hypertension, acute SSEHs must be suspected when they present with atraumatic back pain and signs of spinal cord compression. The interval to surgical decompression greatly influences the prognosis for neurological recovery.

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