Central nervous system magnetic resonance imaging aspects of superficial siderosis

Aspectos da ressonância magnética do sistema nervoso central de siderose superficial

IMAGES IN NEUROLOGY

Central nervous system magnetic resonance imaging aspects of superficial siderosis

Aspectos da ressonância magnética do sistema nervoso central de siderose superficial

Tarso Adoni^I; Eduardo Genaro Mutarelli^II; Jerusa Smid^III; Luiz Antônio Pezzi Portela^IV

^IMD, PhD; Hospital Sírio-Libanês, São Paulo SP, Brazil

^IIMD, PhD, Fellow of the American Academy of Neurology; Hospital Sírio-Libanês, São Paulo SP, Brazil

^IIIMD, PhD; University of São Paulo School of Medicine (FM-USP), São Paulo SP, Brazil

^IVMD, PhD; Fleury Group of Diagnostic Medicine, São Paulo SP, Brazil

^{Correspondence}

A 68-year-old man was evaluated with progressive gait difficulties, first noticed three years before. Neurological examination disclosed paraparetic spastic gait and lower limbs hyperreflexia with bilateral Babinski sign; mild left upper limb cerebellar ataxia; and left hearing loss. The magnetic resonance imaging (MRI) showed rims of hypointensity on T2 around the brainstem, cerebellum, and spinal cord, which was consistent with radiological diagnosis of superficial siderosis¹ (Figs 1 to 3). There was no previous history of central nervous system (CNS) bleeding or trauma. Conventional angiographies were unremarkable. This rare case of primary superficial siderosis highlights the classic triad of hearing loss, ataxia, and myelopathy and its pathognomonic MRI findings².

Received 23 May 2012

Received in final form 18 June 2012

Accepted 25 May 2012

Conflict of interest: There is no conflict of interest to declare.

• 1. Kumar N. Neuroimaging in superficial siderosis: an in-depth look. AJNR Am J Neuroradiol 2010;31:5-14.
• 2. Kumar N, Cohen-Gadol AA, Wright RA, Miller GM, Piepgras DG, Ahlskog JE. Superficial siderosis. Neurology 2006;66:1144-1152.

Publication Dates

• Publication in this collection
  08 Oct 2012
• Date of issue
  Oct 2012