Owl-eyes sign (spinal cord)

Last revised by Frank Gaillard ◉ ◈ on 30 Jan 2025

Citation, DOI, disclosures and article data

Citation:

Gaillard F, Sharma R, Altadill A, et al. Owl-eyes sign (spinal cord). Reference article, Radiopaedia.org (Accessed on 17 Mar 2025) https://doi.org/10.53347/rID-44588

DOI:

https://doi.org/10.53347/rID-44588

Permalink:

https://radiopaedia.org/articles/44588?embed_domain=external.radpair.com%2527%255B0%255D

rID:

44588

Article created:

28 Apr 2016, Frank Gaillard ◉ ◈

Disclosures:

At the time the article was created Frank Gaillard had no recorded disclosures.

View Frank Gaillard's current disclosures

Last revised:

30 Jan 2025, Frank Gaillard ◉ ◈

Disclosures:

At the time the article was last revised Frank Gaillard had no financial relationships to ineligible companies to disclose.

View Frank Gaillard's current disclosures

Revisions:

13 times, by 8 contributors - see full revision history and disclosures

Systems:

Central Nervous System, Spine

Sections:

Signs

Synonyms:

Owl's eyes sign
Fried-eggs sign
Fried-eggs sign (spinal cord)
Snake-eyes sign (spinal cord)
Snake-eyes sign

The owl-eyes sign, also known as snake-eyes sign or fried-eggs sign, represents bilaterally symmetric circular to ovoid foci of high T2-weighted signals in the anterior horn cells of the spinal cord and is seen on axial MR imaging. The sagittal corollary is a "pencil-like" vertical linear high T2-weighted signal extending usually over a number of segments.

Although typically described as one of the patterns in spinal cord infarction affecting the anterior spinal artery ^1,2, it is seen in multiple other clinical settings and represents the result of increased metabolic activity (thus vulnerability) and reduced collateral supply of the anterior horns of the spinal cord.

This pattern is seen in the following scenarios ^1-8:

anterior spinal artery ischaemia: common
chronic compressive myelopathy: common
- spondylotic
- ossification of the posterior longitudinal ligament (PLL)
- Hirayama disease
- cervical spinal longitudinal epidural collection (SLEC) due to spontaneous intracranial hypotension
amyotrophic lateral sclerosis (ALS)
neuromyelitis optica (NMO): uncommon
poliomyelitis-like syndrome: rare
Hopkins syndrome: rare
spinal muscular atrophy: rare ³

References

1. Masson C, Pruvo JP, Meder JF et-al. Spinal cord infarction: clinical and magnetic resonance imaging findings and short term outcome. J. Neurol. Neurosurg. Psychiatr. 2004;75 (10): 1431-5. J. Neurol. Neurosurg. Psychiatr. (full text) - doi:10.1136/jnnp.2003.031724 - Free text at pubmed - Pubmed citation
2. Novy J, Carruzzo A, Maeder P et-al. Spinal cord ischemia: clinical and imaging patterns, pathogenesis, and outcomes in 27 patients. Arch. Neurol. 2006;63 (8): 1113-20. doi:10.1001/archneur.63.8.1113 - Pubmed citation
3. C F Hsu, C Y Chen, Y S Yuh, Y H Chen, Y T Hsu, R A Zimmerman. MR findings of Werdnig-Hoffmann disease in two infants. American Journal of Neuroradiology. 19 (3): 550. Pubmed
4. Friedman DP, Tartaglino LM, Fisher AR, Flanders AE. MR imaging in the diagnosis of intramedullary spinal cord diseases that involve specific neural pathways or vascular territories. AJR. American journal of roentgenology. 165 (3): 515-23. doi:10.2214/ajr.165.3.7645462 - Pubmed
5. You JY, Lee JW, Lee E, Lee GY, Yeom JS, Kang HS. MR Classification System Based on Axial Images for Cervical Compressive Myelopathy. Radiology. 276 (2): 553-61. doi:10.1148/radiol.2015142384 - Pubmed
6. Mizuno J, Nakagawa H, Chang HS, Hashizume Y. Postmortem study of the spinal cord showing snake-eyes appearance due to damage by ossification of the posterior longitudinal ligament and kyphotic deformity. Spinal cord. 43 (8): 503-7. doi:10.1038/sj.sc.3101727 - Pubmed
7. Al-Mefty O, Harkey LH, Middleton TH, Smith RR, Fox JL. Myelopathic cervical spondylotic lesions demonstrated by magnetic resonance imaging. Journal of neurosurgery. 68 (2): 217-22. doi:10.3171/jns.1988.68.2.0217 - Pubmed
8. Sun Y, Pahwa S, Vasireddy R, Barty A, Raslau F. Pearls & Oy-Sters: Bibrachial Amyotrophy From a Dural Tear. Neurology. 2024;102(7):e209256. doi:10.1212/wnl.0000000000209256 - Pubmed