Owl-Eyes Sign of the Spinal Cord in Spinal Muscular Atrophy

Nur Aisyah Kosnin, Fattah Rahiman Ghazali, Mohd Ezane Aziz

Abstract


The "owl-eyes" sign is a rare and unique radiological finding that can be seen in the anterior horn cells of the spinal cord as bilateral symmetrical hyperintense circular or ovoid foci on T2-weighted (T2W) axial magnetic resonance imaging (MRI) sequences. There are various clinical conditions that have been linked to this sign, as in our case report, it is seen in a case of spinal muscular atrophy.  We report a case of 16-year-old male patient who had no known medical illness and presented with deformity of the back for the past one year without any neurological deficit. His MRI whole spine showed thoracic spine scoliosis with “owl-eyes’’ sign in the spinal cord as well as left erector spinae muscle atrophy, leading to the diagnosis of spinal muscular atrophy.

Keywords


‘’Owl-eyes’’ sign, magnetic resonance imaging (MRI), scoliosis, spinal muscular atrophy

Full Text:

PDF

References


Kolb SJ, Kissel JT. Spinal muscular atrophy: A timely review. Archives of Neurology. Aug 2011; 68(8): 979–84. DOI: 10.1001/archneurol.2011.74

Muralidharan K, Wilson RB, Ogino S, Nagan N, Curtis C, Schrijver I. Population carrier screening for spinal muscular atrophy: A position statement of the association for molecular pathology. Journal of Molecular Diagnostics. 2011; 13(1): 3–6. DOI: 10.1016/j.jmoldx.2010.11.012

Sari DM, Biben V, Wiwaha G, Hilmanto D. Association between spinal muscular atrophy type and delayed diagnosis and the risk of spinal deformity in Indonesian patients. European Journal of Medical Research. 2023; 28(1): 130. DOI: 10.1186/s40001-023-01098-3

Kim H, Kim HS, Moon ES, Yoon CS, Chung TS, Song HT, et al. Scoliosis imaging: What Radiologists should know. Radiographics. 2010; 30(7): 1823–42. DOI: 10.1148/rg.307105061

Kolb SJ, Kissel JT. Spinal Muscular Atrophy. Neurologic Clinics. 2015; 33 (4): 831–46. DOI: 10.1016/j.ncl.2015.07.004

Liu GC, Jong YJ, Chiang CH, Yang CW. Spinal muscular atrophy: MR evaluation. Pediatric Radiology. 1992; 22(8), 584–586. DOI: 10.1007/BF02015357

Fontanella MM, Zanin L, Bergomi R, Fazio M, Zattra CM, Agosti E, et al. Snake-eye myelopathy and surgical prognosis: Case series and systematic literature review. Journal of Clinical Medicine. 2020; 9(7): 2197. DOI: 10.3390/jcm9072197

Iwasaki Y, Abe H, Isu T, Miyasaka K. CT myelography with intramedullary enhancement in cervical spondylosis. Journal of Neurosurgery. 1985; 63(3): 363-366. DOI:10.3171/jns.1985.63.3.0363

Jinkins JR, Bashir R, Al-Mefty O, Al-Kawi MZ, Fox JL. Cystic necrosis of the spinal cord in compressive cervical myelopathy: demonstration by iopamidol CT-myelography. American Journal of Roentgenology. 1986; 147(4): 767–775. DOI: 10.2214/ajr.147.4.767

Mawad ME, Rivera V, Crawford S, Ramirez A, Breitbach W. Spinal cord ischemia after resection of thoracoabdominal aortic aneurysms: MR findings in 24 patients. American Journal of Roentgenology. 1990;155(6):1303-7. DOI:10.2214/ajr.155.6.2122684

Hsu CF, Chen CY, Yuh YS, Chen YH, Hsu YT, Zimmerman RA. MR Findings of Werdnig-Hoffmann Disease in Two Infants. American Journal of Neuroradiology. 1998; 19(3): 550–552.

Scalia G, Costanzo R, Brunasso L, Garufi G, Bonosi L, Ricciardo G, et al. Correlation between “Snake-Eyes” Sign and Role of Surgery with a Focus on Postoperative Outcome: A Systematic Review. Brain Sciences. 2023; 13(2):301. DOI: 10.3390/brainsci13020301




Copyright (c) 2023 Journal of Biomedical and Clinical Sciences (JBCS)

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

 

Flag Counter           

                     

                                              Copyright © 2016 AMDI Publisher, Universiti Sains Malaysia.
Disclaimer : This website has been updated to the best of our knowledge to be accurate. However, Universiti Sains Malaysia shall not be liable for any loss or damage caused by the usage of any information obtained from this web site.
                                            Best viewed: Mozilla Firefox 4.0 & Google Chrome at 1024 × 768 resolution.