Non-traumatic anterior spinal cord infarction in a novice surfer: A case report

Chung, Hsin-Yeh; Sun, Shu-Fen; Wang, Jue‐Long; Lai, Ping-Hong; Hwang, Chiao-Wen

doi:10.1016/j.jns.2010.11.026

Cited by 24 publications

(10 citation statements)

References 12 publications

(13 reference statements)

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“…Five published papers detailed the time between symptom onset and imaging, and conventional spinal cord MR imaging was abnormal within 2–12 hours. 1,2,4,5,8 One case reported by Kelly and Wright 3 was initially normal but was subsequently abnormal on repeat imaging within 24 hours of the initial MR imaging. 3 DWI with ADC mapping has inconsistently demonstrated restricted diffusion in cases of surfer’s myelopathy.…”

Section: Discussionmentioning

confidence: 99%

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Surfer's Myelopathy: A Radiologic Study of 23 Cases

Nakamoto

Siu

Hashiba

et al. 2013

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE Surfing is an uncommon cause of an acute nontraumatic myelopathy. This study describes the MR imaging characteristics and clinical correlates in 23 subjects with surfer’s myelopathy. MATERIALS AND METHODS This was a retrospective review of 23 cases of surfer’s myelopathy from 2003–2012. Spinal cord MR imaging characteristics and neurologic examinations with the use of the American Spinal Injury Association scale were reviewed. Logistic regression was used to determine associations between MR imaging characteristics, American Spinal Injury Association scale, and clinical improvement. RESULTS All subjects (19 male, 4 female; mean age, 26.3 ± 7.4 years) demonstrated “pencil-like,” central T2-hyperintense signal abnormalities in the spinal cord extending from the midthoracic region to the conus with associated cord expansion and varying degrees of conus enlargement on spinal cord MR imaging within 24 hours of symptom onset. T1 signal was normal. Faint gadolinium enhancement was present in a minority. Although there was a strong correlation between initial American Spinal Injury Association score and clinical improvement (P = .0032), MR imaging characteristics were not associated with American Spinal Injury Association score or clinical improvement. CONCLUSIONS Surfer’s myelopathy should be considered in the radiographic differential diagnosis of a longitudinally extensive T2-hyperintense spinal cord lesion. MR imaging characteristics do not appear to be associated with severity on examination or clinical improvement.

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Section: Discussionmentioning

confidence: 99%

“…8,10 Conventional spinal angiograms were normal when performed in previously described cases. 1,5,10 …”

Section: Discussionmentioning

confidence: 99%

Surfer's Myelopathy: A Radiologic Study of 23 Cases

Nakamoto

Siu

Hashiba

et al. 2013

AJNR Am J Neuroradiol

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“…3 Several etiologies of anterior spinal cord ischemia triggered by prolonged and repeated back hyperextension have been proposed, including: (1) an ischemic event to the watershed zone between the anterior and posterior spinal circulation caused by vasospasm of the artery of Adamkiewicz; (2) avulsion of the perforating arteries; and (3) borderline perfusion, as a result of tension of the spinal cord. 6 Others have suggested that surfer's myelopathy is a result of a venous infarction caused by dynamic vena cava obstruction by the liver in a prone position, combined with a Valsalva maneuver when maneuvering from prone to standing. 6 Others have suggested that surfer's myelopathy is a result of a venous infarction caused by dynamic vena cava obstruction by the liver in a prone position, combined with a Valsalva maneuver when maneuvering from prone to standing.…”

Section: Surfer's Myelopathymentioning

confidence: 99%

Some Unusual Sports-Related Neurologic Conditions

Conidi¹

2014

CONTINUUM: Lifelong Learning in Neurology

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The syndromes described in this article range from relatively minor syndromes that cause discomfort or abnormal movement to potentially devastating cerebrovascular or myelopathic syndromes. Although the disorders described in this article are not common, they can affect individuals involved in sports at all levels, from the novice to the elite athlete, and may present to any neurologist. Neurologists should be aware of the potential for these syndromes to occur as a consequence of athletic activities in order to provide the most appropriate diagnosis, management, and counseling.

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“…Twenty-one cases of surfer's myelopathy have been described in the literature [3,[8][9][10][11][12][13][14][15][16]. These people develop progressive bilateral lower limb pain, paresthesia, and paraplegia during their first lesson.…”

Section: Surfer's Myelopathymentioning

confidence: 99%