Owl-eyes sign (spinal cord)

Last revised by Dr Daniel J Bell on 15 Oct 2021

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 1-7

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Cases and figures

  • Figure 1
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  • Figure 2: barn owl
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  • Case 1: ischemia
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  • Case 2: anterior horn syndrome
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  • Case 3: compressive myelopathy
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