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Images in Neurology |

A Giant Spinal Cord Cavity

Gabriella Zara, MD
Arch Neurol. 2009;66(10):1294-1295. doi:10.1001/archneurol.2009.220.
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A 27-year-old woman complained of neck pain, dizziness, and postural instability that had begun 6 months before. She did not have a history of cervical trauma. The result of her neurologic examination was normal except for a mild contraction of the upper trapezius muscle. Spinal radiography showed reversal of cervical lordosis with curve inversion between C5 and C6. No sign of scoliosis was reported. Spinal magnetic resonance imaging sequences revealed a large hydromyelic cavity between C2 and C4 (cranial-caudal diameter, 4 cm; transverse diameter, 1.5 cm). The spinal cord was thin and splayed without intraparenchymal abnormalities (Figure 1 and Figure 2). Cerebral, dorsal, and lumbar magnetic resonance imaging; upper and lower extremity motor evoked potentials; and spinal somatosensory evoked potentials did not show any abnormalities. Symptoms could be associated with reversal of cervical lordosis and not with the spinal cord cavity. A surgical approach has not yet been attempted.

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Figure 1.

A T2-weighted magnetic resonance imaging sagittal sequence of the cervical spine demonstrated a large cavity between C2 and C4. H indicates head.

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Figure 2.

A T1-weighted magnetic resonance imaging axial sequence of the cervical spine demonstrated the maximal transverse diameter of the cavity. H indicates head; L, left; P, posterior; Ph, phase; and R, right.

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