IMAGES IN MEDICINE
"Anchor"-shaped bright posterior column in a patient with vitamin B12 deficiency myelopathy
1 Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
2 Chhatrapati Shahuji Maharaj Medical University, Lucknow, India
Correspondence to:
Dr V K Paliwal, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Rae Bareli Road, Lucknow 226014, India; dr_vimalkpaliwal@rediffmail.com
Keywords: neurology; nutritional support; vitamin B12 deficiency myelopathy; neuroradiology
| The first 150 words of the full text of this article appear below. |
A 50-year-old strict vegetarian lady presented with progressive gait instability and paraesthesia of all four limbs lasting 8 months. She had spastic ataxic quadriparesis with pan sensory loss below the C3/4 spinal segment, sensory polyneuropathy, prolonged visual evoked potentials and unrecordable somatosensory evoked potentials. Her serum vitamin B12 concentration was 78 pg/ml. Spinal MRI showed diffuse cervicothoracic cord swelling (fig 1A,B) and posterior column contrast enhancement (fig 2A). The bright posterior column in vitamin B12 deficiency myelopathy is known1 and has been variously described as an inverted V or inverted rabbit ear sign,2 with these terms describing the shape of the posterior column on post-contrast T1-weighted MRI spine axial sections. Our case represents a severe B12 deficiency myelopathy with involvement of posterior, anterior and pyramidal tracts in the cervicodorsal spinal cord, as was evident on clinical examination. This resulted in contrast enhancement of the posterior and
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
