-Case Reports-

Two Cases of Subacute Combined Degeneration: Magnetic Resonance Findings

Susumu Okada¹, Tomoyuki Kuwako¹, Hidenobu Nakajo¹, Makiko Ishihara², Fumio Uchiyama³, Rinnosuke Obo⁴, Norio Yokose⁵ and Makoto Hamamoto⁵

¹Department of Radiology, Nippon Medical School Chiba-Hokusoh Hospital
²Department of Radiology, Nippon Medical School
³Department of Radiology, Ebina-Sogo Hospital
⁴Department of Internal Medicine, Fuchu-Keijinkai Hospital
⁵Department of Internal Medicine, Nippon Medical School Chiba-Hokusoh Hospital

We report two cases of subacute combined degeneration. Both patients had undergone total gastrectomy. The chief complaints were numbness in both upper extremities in case 1 and numbness in both the upper and lower extremities and gait disturbance in case 2. The pain, temperature, and vibration senses of both patients were decreased. Laboratory examinations showed macrocytic anemia and a decreased serum vitamin B12 level in both cases. In both cases T2-weighted magnetic resonance images showed an area of hyperintensity in the dorsal columns of the cervical spinal cord. The patients were treated with vitamin B12. The abnormal signals had disappeared on follow-up magnetic resonance examination 1 year later in case 1 and 3 months later in case 2. These patients showed neurological improvement, but the numbness in the upper extremities persisted even after the area of abnormal signal intensity had disappeared in case 1.

J Nippon Med Sch 2006; 73: 328-331

Keywords
subacute combined degeneration, vitamin B12, magnetic resonance

Correspondence to
Susumu Okada, Department of Radiology, Nippon Medical School Chiba-Hokusoh Hospital, 1715 Kamagari, Inba-mura, Inba-gun, Chiba, 270-1694, Japan
okada@nms.ac.jp

Received, August 21, 2006
Accepted, September 22, 2006