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

• Published in: Spinal cord 2005-08, Vol.43 (8), p.503-507
• Main Authors: Mizuno, J, Nakagawa, H, Chang, H-S, Hashizume, Y
• Format: Article
• Language: English
• Subjects: Aged; Anatomy; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; case-report; Cerebrospinal fluid. Meninges. Spinal cord; Cerebrospinal fluid. Spinal cord. Spinal roots. Spinal nerves; Cervical Vertebrae; Human Physiology; Humans; Injuries of the nervous system and the skull. Diseases due to physical agents; Kyphosis - pathology; Laminectomy - adverse effects; Longitudinal Ligaments - pathology; Magnetic Resonance Imaging - methods; Male; Medical sciences; Nervous system (semeiology, syndromes); Neurochemistry; Neurology; Neuropsychology; Neurosciences; Neurosurgery; Ossification of Posterior Longitudinal Ligament - pathology; Postmortem Changes; Spinal Cord - pathology; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Traumas. Diseases due to physical agents
• ISSN: 1362-4393; 1476-5624
• DOI: 10.1038/sj.sc.3101727

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.