Case Report

Spinal Cord (2005) 43, 503–507. doi:10.1038/sj.sc.3101727; published online 8 March 2005

Postmortem study of the spinal cord showing snake-eyes appearance due to damage by ossification of the posterior longitudinal ligament and kyphotic deformity

J Mizuno1, H Nakagawa1, H-S Chang1 and Y Hashizume2

  1. 1Department of Neurological Surgery, Aichi Medical University, Aichi, Japan
  2. 2Institute of Medical Science for Aging, Aichi Medical University, Aichi, Japan

Correspondence: J Mizuno, Department of Neurological Surgery, Aichi Medical University, 21 Karimata Yazako Nagakute, Aichi-gun, Aichi 480-1195, Japan

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Abstract

Clinical design:

 

A case report.

Objectives:

 

To elucidate the clinical role of snake-eyes appearance in this case, correlation between radiological, clinical and postmortem study was performed.

Setting:

 

Aichi, Japan.

Case report:

 

A 73-year-old man developed weakness and pain in the upper limbs due to kyphotic deformity secondary to laminectomy for cervical ossification of the posterior longitudinal ligament. Axial magnetic resonance imaging revealed snake-eyes appearance from C4 to C6. He died of acute myocardial infarction 3 months after anterior decompressive surgery.

Results:

 

A postmortem examination of the cervical spinal cord showed small cystic six necrotic areas at the junction of the central gray matter and the ventrolateral posterior column, one in the right and one in the left, in association with neuronal loss in the anterior horn.

Conclusions:

 

Bilateral small intramedullary high-signal areas known as 'snake-eyes appearance' located around the central gray matter and the ventrolateral posterior column, are associated with neuronal loss in the compressed anterior horn that played an important role in worsening weakness of the upper limbs.

Keywords:

snake-eyes appearance, compression myelopathy, magnetic resonance imaging, cystic necrosis, neuronal loss

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