Cervical spondylotic myelopathy (CSM) is the most common nontraumatic spinal cord condition in people over 55 years of age. This disorder is due to compression of the spinal cord by a stenotic cervical canal. A 55-year-old hypertensive patient with a clinical picture that simulated a stroke is described, due to a sudden onset of a right brachiocrural motor deficit, with elevated blood pressure levels in the range of hypertensive crisis. Hours later the patient presented the same motor deficit contralaterally: Computed tomography and magnetic resonance imaging of the brain showed no abnormality. The finding of atrophy in the interosseous muscles was striking. Cervical magnetic resonance imaging was performed showing a narrow spinal canal, with spinal cord hyperintensity in T2 sequences at levels C2 to C6. The most frequent causes of stroke mimics are tumors and metabolic toxic disorders. Spinal disorders represent 1.7% of all cases, CSM being a rare cause.
Spinal cord injury
Neuroimagen de la reorganización cortical en pacientes con lesión medular.
Introduction: Spinal cord injury promotes an afferent and efferent disconnection from the cortex causing neurologic deficits. Many imaging studies have shown that neuroplasticity occurs after effective treatments in patients with spinal cord injury.
Objective: The purpose of the study was to make a bibliographic review of the treatments applied after spinal cord injury, studying neuroplasticity and how supraespinal structures react to these treatments as shown by neuroimaging tools such as functional magnetic resonance imaging (fMRI).
Development: Treatments including cell transplantation, antibodies against myelin inhibitors or against antagonists of their receptors, surgical rebuilding methods and motor rehabilitation, can compensate the loss of function of the areas with injury. This improvement is characterized by cortical activation changes.
Conclusion: We conclude that the treatments currently used produce good results in relation to the sensorimotor reorganization in patients with spinal cord injury. fMRI is a valuable tool for the study of cerebral changes in spinal injury.
