Clinics in diagnostic imaging (190). Subacute combined degeneration of the spinal cord (SCD).

Author: Mark Christopher PEARCE ¹ ; Garry CHOY ² ; Robert Chun CHEN ³
Author Information

1. Department of Medical Imaging, Saskatoon Health Region, Saskatoon, SK, Canada.
2. Department of Diagnostic Radiology, Massachusetts General Hospital, Boston, MA, USA.
3. Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
Publication Type:Journal Article
Keywords: T2 hyperintensity of the spinal cord; subacute combined degeneration; vitamin B12 deficiency
From:Singapore medical journal 2018;59(9):460-464
CountrySingapore
Language:English
Abstract: A 54-year-old man presented with progressive onset of lower limb paraesthesias, sensory ataxia, gait instability and lower limb weakness. Laboratory findings revealed low serum B12 levels. Magnetic resonance imaging showed long-segment symmetrically increased T2 signal within the dorsal columns of the spinal cord in the lower thoracic spine. The conglomeration of findings was consistent with a diagnosis of subacute combined degeneration of the spinal cord (SCD). Aside from mild residual paraesthesias, the patient's symptoms largely resolved after treatment with intramuscular injections of vitamin B12. The clinical presentation, pathophysiology, clinical and radiologic differential diagnosis, and management of SCD were described.