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Updated: Sep 21, 2026
Diffusion Tensor Magnetic Resonance Imaging in Chronic Spinal Cord Compression
Published on: May 7, 2019
MRI findings in acute idiopathic transverse myelopathy in children
Savvas Andronikou1, Glenda Albuquerque-Jonathan, Jo Wilmshurst
1Department of Paediatric Radiology, Red Cross Children's Hospital, University of Cape Town and School of Child and Adolescent Health, Klipfontein Road, Cape Town, South Africa. docsav@mweb.co.za
Objective:
To describe the clinical and MRI findings in three children with acute idiopathic myelopathy (AIM).
Materials And Methods:
Retrospective review of the clinical presentation, MRI findings and outcome of three patients diagnosed with acute idiopathic transverse myelitis.
Results:
Of note was the swift onset of symptoms in all patients, without any preceding illness or history of vaccination in two of the patients, and the rapid resolution of symptoms on steroid therapy in all the patients. MRI showed T2-weighted hyperintensity and patchy enhancement with gadolinium, but the extensive cord involvement did not correlate with the severity of presentation or outcome.
Conclusions:
Our findings do not support that MRI evidence alone of diffuse myelopathy is a predictor of poor outcome in childhood AIM.
Insights
Acute idiopathic myelopathy (AIM) in children presents with rapid symptoms and responds well to steroids. Extensive MRI findings in AIM do not predict poor outcomes in pediatric patients.
Area of Science:
- Pediatric Neurology
- Neuroimaging
- Inflammatory Myelopathies
Background:
- Acute idiopathic myelopathy (AIM) is a rare neurological condition affecting the spinal cord.
- Understanding the clinical presentation and MRI characteristics is crucial for diagnosis and prognosis.
Observation:
- Three pediatric cases of AIM were reviewed retrospectively.
- Clinical data included symptom onset, preceding illnesses, vaccination history, and treatment response.
- MRI findings focused on T2-weighted hyperintensity and gadolinium enhancement patterns.
Findings:
- AIM presented with swift symptom onset in all cases.
- Two patients had no preceding illness or vaccination history.
- All patients showed rapid symptom resolution with steroid therapy.
- MRI revealed T2 hyperintensity and patchy enhancement, but extensive cord involvement did not correlate with clinical severity or outcome.
Implications:
- MRI findings alone, such as diffuse myelopathy, may not be a reliable predictor of poor outcomes in childhood AIM.
- This study highlights the importance of clinical response to treatment in assessing prognosis for pediatric AIM.
