Boldin et al correlated neurologic outcome with postoperative magnetic resonance images (MRI) in a patient with a cervical spine cord injury (SCI). The authors are from the Medical University of Graz in Austria.
Patient evaluation:
(1) Patients with acute traumatic cervical spinal cord injury underwent surgery 2-9 hours after trauma.
(2) The followup MRI was done 2 weeks after surgery.
(3) Motor outcome was assessed at 2 to 5 years post-injury (median 3 years).
MRI features of hemorrhage:
(1) T1 weighted spin echo images - high signal intensity
(2) T2 weighted spin echo images - low signal intensity
MRI features of edema:
(1) T1 weighted spin echo images - no signal changes
(2) T2 weighted spin echo images - high intensity, intramedullary
Parameters:
(1) length of hematoma in mm
(2) amount of edema
|
Length of Hematoma |
Amount of Edema |
Prognosis |
|
median 10.5 mm (4 - 15 mm) |
median 66.5 mm (40 - 150 mm) |
complete SCI (ASIA A) |
|
median 4 mm (2 - 9 mm) |
small |
incomplete SCI (ASIA B) |
|
< 4 mm |
small |
good (ASIA C and D) |
Each mm increase in the length of hematoma increases the risk of ASIA A 1.8 times.
Each mm increase in length of edema increased rate of ASIA A 1.15 times.
|
Length of Hematoma |
Amount of Edema |
Prognosis |
|
0 - 1.99 mm |
none to small (<= 40 mm) |
good |
|
2.0 - 3.99 mm |
small (< 58 mm) |
good or incomplete |
|
4 - 9 mm |
small (< 58 mm) |
probably incomplete |
|
4 - 9 mm |
large (>= 58 mm) |
probably complete |
|
> 9 mm |
any |
complete |
|
> 9 mm |
large (>= 58 mm) |
complete |
Specialty: Neurology
