Patient is 60 year old diabetic female who presented with 2 day history of quadriparesis. Brain MRI revealed extensive small vessel occlusive white matter changes. MRI of the cervical spine reveals T2-weighted images showed an abnormal long segment increase in signal intensity affecting the anterior two third of the spinal cord. On axial T2-weighted images, ASCI appeared as two rounded intramedullary high-intensity lesions (the so-called “owl’s eye” appearance). Spinal cord ischemia most often occurs in the anterior spinal artery (ASA) territory. ASA is a blood vessel that supplies the anterior portion of the spinal cord.
Hyperintensities on T2-weighted images are nonspecific for ischemia. It can also be seen in
• Demyelinating plaques
• Myelitis
• Non-haemorrhagic contusion
Nevertheless, high T2 signal located in the anterior two-thirds of the spinal cord is suggestive of ASCI.
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