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Progressive Fatal Myelopathy Secondary to Isolated Spinal Cord Vasculitis
Arie Fisher1, Habib Rahman1, Michael Farrell2
1Department of Neurology, University Hospital Galway, Galway, Ireland.
Frontiers in Neurology
|January 10, 2018
Summary
This case study details a patient with progressive myelopathy due to spinal cord necrosis and meningovascular inflammation. Early immunomodulatory treatment might improve outcomes for this rare myelitis cause.
Area of Science:
- Neurology
- Immunology
- Pathology
Background:
- A 56-year-old woman presented with a year-long history of progressive neurological deficits.
- Cervical spine MRI revealed significant signal abnormalities.
Observation:
- The patient experienced rapid deterioration, developing myelopathy, quadriplegia, and requiring mechanical ventilation.
- Intravenous steroids and subsequent immunomodulatory therapies were ineffective.
Findings:
- Histopathology confirmed spinal cord necrosis with meningovascular inflammation affecting spinal arteries and veins.
- Evidence of prior anterior spinal artery occlusion was noted, with changes localized to the spinal cord.
Implications:
- This case highlights an unusual etiology of myelitis.
- Prompt and aggressive immunomodulatory treatment may be crucial for managing such conditions and potentially altering patient outcomes.
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