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Subacute combined degeneration of the cord

Case contributed by Ali Alsmair
Diagnosis almost certain

Presentation

Patient presented with memory loss, gait ataxia, and distal muscle weakness.

Patient Data

Age: 45 years
Gender: Female

There is an abnormal high T2 cord signal in the dorsal columns over a relatively long segment (from C2 to C7), giving the Inverted V sign (spinal cord) appearance, likely representing subacute combined degeneration.

Disc herniations at C3-C4, C4-C5 and C5-C6 levels are noted.

Case Discussion

Subacute combined degeneration (SACD) is caused by Vitamin B12 deficiency
Involvement of the cord indicates the presence of neurological deficit.

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