Contribution of magnetic resonance imaging in subacute combined degeneration of the spinal cord due to vitamin B12 deficiency

Subacute combined degeneration (SCD) of the spinal cord is known to present histopathologically degenerative lesions in the spinal cord, but few studi es on the neuroradiological findings have so far been reported. We present the interest of initial and follow-up MR findings in three cases of SCD. In the three cases, a causal event precipitated the onset of neurological sym ptoms: general anesthesia for the first and the third one and folio acid tr eatment for the second one. Clinical evolution was favorable after specific treatment with nearly total recovery. The initial MR study disclosed lesio ns predominantly involving the posterior columns of the spinal cord: high i ntensity on T2 weighted image was seen in the initial MR study and disappea red three months after treatment in correlation with good recovery, but wit h a delay. The recognition of this MR pattern suggests that MRI may be used in conjonction with clinical assessment to confirm the diagnosis and to mo nitor the efficacity of treatment in SCD.