Related Experiment Video
Updated: Sep 24, 2025
Author Spotlight: Assessing Ischemic Stroke Damage Through Middle Cerebral Artery Occlusion Model
Published on: August 11, 2023
A case of cervical OPLL and DISH mimicking stroke
Rudra Mangesh Prabhu1, Tushar N Rathod2, Shubhranshu S Mohanty2
1Department of Orthopaedics, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India.
Background:
Ossification of the posterior longitudinal ligament (OPLL) is a progressive disorder that mostly involves the cervical spine. It is more prevalent in East Asian countries. Patients typically present with the gradual onset of myelopathy, while about 5% show rapid progression.
Case Description:
A 51-year-old diabetic and hypertensive male presented with a left-sided hemiparesis following trivial trauma. The first diagnosis was a stroke, but the subsequent workup proved negative. Subsequently, the MRI and CT studies demonstrated significant cord compression due to OPLL extending from C2 to C7. There was also a heterogeneous hyperintense intramedullary cord signal indicative of edema/myelomalacia in the retro- odontoid region. The CT also diagnosed C2-C7 diffuse idiopathic skeletal hyperostosis.
Conclusion:
Patients with cervical myelopathy due to OPLL rarely present about 5% of the time with the acute onset of neurological deficit following minor trauma. Certainly, one must consider high cervical OPLL as responsible for hemiparesis in a patient whose brain MR has ruled out a stroke.
