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  • i am new here-recent MRI for wife shows area at c3 to c4 spinal cord

    My wife has numbness to temperature on complete left side of her body except head and on the right side her arm has limited motion with weakness especially the further she extends her arm. She is 31 years old with no prior anything or family history she did fall about 5 feet the week before but had no soreness or bruising and was fine all week. Since the night this has came on we have been to the ER with xrays and cat scans that showed nothing so they recommended orthopedics which had MRI done of whole spinal cord it showed c3 and c4 brighter than the rest of spinal cord. The orthopedic said it could be a contusion or the outer sheathing damaged with the nerves exposed but said he doesn't know so he is sending us to an neurologist and it sounds like we may be doing a brain MRI next. I am not sure what i am expecting writing this just thought i would share and see what you'll thoughts we're. I can't sleep anyway to worried about the wife. I do work 2 full time jobs and have 2 kids one of them 1 year old so it may take me time in between writings thanks

  • #2
    Are the bones surrounding the injury site stable? How long ago did this happen? It sounds as if she has what is called an incomplete spinal cord injury. This is where the cord is damaged but not severed. If this is a recent injury, her prognosis is unknown.

    You are being sent to a neurologist because it is not bone. Orthopedic doctors only deal with bones. Neurologists deal with the spinal column as well as the brain. The neurologist will be able to explain the injury better and give you information regarding her long term recovery. You do not say where you live but she does need a neurologist that specializes in SCI. I am the mom/caregiver of an incomplete C-2 with TBI and Ryan has educated his neurologist (and shocked him with increased recovery at each follow-up visit. This doctor has never seen anyone like Ryan before (no one in this area has, even the specialists at rehab in Atlanta underestimated his potential.

    Biggest thing is do not freak out. There are many people on this board who can not only give you information and support, they are living lives with injuries more pronounced that it sounds like your wife's is. Life is different but can be meaningful and productive. Having small children is a challenge.

    I do not mean to sound cold and uncaring, but it sounds like she is still very functional and therefore is luckier than most SCI patients.--eak
    Elizabeth A. Kephart, PHR
    mom/caregiver to Ryan-age 21
    Incomplete C-2 with TBI since 3/09

    Comment


    • #3
      Hello and welcome, wpm. It sounds like the MRI of your wife's spinal cord has revealed some areas of inflammation, but without further testing it's impossible to say what they signify - so it's good she's having further workup with a neurologist. Try to take it a step at a time, I know this is a shocking and unexpected development and it's very stressful. You'll find a lot of good information on this site. Keep us posted.
      MS with cervical and thoracic cord lesions

      Comment


      • #4
        Did the physician mention MS (multiple sclerosis)? These findings could be related to MS, esp. if they are looking now at the brain. Unfortunately she is at the most common age for this diagnosis, and it is more common in females. What is her ethnic background? It is most common in those who are Caucasian from Northern European backgrounds.

        MS is not a death sentence, and there are treatments that can slow its progression. Please come back and post more so that we can help you with resources if that is her diagnosis.

        (KLD)
        The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

        Comment


        • #5
          amanda/response

          Originally posted by ekephart View Post
          Are the bones surrounding the injury site stable? How long ago did this happen? It sounds as if she has what is called an incomplete spinal cord injury. This is where the cord is damaged but not severed. If this is a recent injury, her prognosis is unknown.

          You are being sent to a neurologist because it is not bone. Orthopedic doctors only deal with bones. Neurologists deal with the spinal column as well as the brain. The neurologist will be able to explain the injury better and give you information regarding her long term recovery. You do not say where you live but she does need a neurologist that specializes in SCI. I am the mom/caregiver of an incomplete C-2 with TBI and Ryan has educated his neurologist (and shocked him with increased recovery at each follow-up visit. This doctor has never seen anyone like Ryan before (no one in this area has, even the specialists at rehab in Atlanta underestimated his potential.

          Biggest thing is do not freak out. There are many people on this board who can not only give you information and support, they are living lives with injuries more pronounced that it sounds like your wife's is. Life is different but can be meaningful and productive. Having small children is a challenge.

          I do not mean to sound cold and uncaring, but it sounds like she is still very functional and therefore is luckier than most SCI patients.--eak

          ekephart thanks for the response and yes the bones are stable. This happened 8 days ago and yes the prognosis is unknown. It sounds like Ryan is a fighter and i wish him the best as well as you. I'm not freaking out and i do realize it could be worse. I am just trying to educate myself. We live in Jacksonville Florida and are waiting for a Neurologist appt. as of right now 4/19 and hoping Monday that will change.

          Comment


          • #6
            amanda/response

            Originally posted by Bonnette View Post
            Hello and welcome, wpm. It sounds like the MRI of your wife's spinal cord has revealed some areas of inflammation, but without further testing it's impossible to say what they signify - so it's good she's having further workup with a neurologist. Try to take it a step at a time, I know this is a shocking and unexpected development and it's very stressful. You'll find a lot of good information on this site. Keep us posted.


            Thanks

            Comment


            • #7
              amanda/response

              Originally posted by SCI-Nurse View Post
              Did the physician mention MS (multiple sclerosis)? These findings could be related to MS, esp. if they are looking now at the brain. Unfortunately she is at the most common age for this diagnosis, and it is more common in females. What is her ethnic background? It is most common in those who are Caucasian from Northern European backgrounds.

              MS is not a death sentence, and there are treatments that can slow its progression. Please come back and post more so that we can help you with resources if that is her diagnosis.

              (KLD)


              She i Caucasian and i do realize it is in the age range but the causes online say Most likely MS occurs as a result of some combination of genetic, environmental and infectious factors, she has no family history and the environmental part i took as organ phosphates like pesticides weed killers which she hasn't been around and infectious factors i took as complications with hospital meds. So i was thinking or hoping it might have something more to do with the fall a week prior to this happening thanks for the info

              Comment


              • #8
                No, it is not chemical exposure. For some reason, MS is more common in those who lived through adolescence north of the 40th parallel (in the northern hemisphere). For example, there is a 5X higher rate of MS in Boston compared to Miami. Where did she grow up?

                As far as genetics, it is as I mentioned, Northern European, especially Scandanavian, Scottish, English, Irish, German, Lowland Countries and French. My mother, who is half Norwegian, has MS, and also has no family history of this. Of course MS was only really well diagnosed since the 1980s (with the advent of MRIs), so those with it previously were often mis-diagnosed with something else.

                The infectious "trigger" theory is an unproven theory, and no actual agent has been identified. It is most probably a virus if it does exist, and transmission, and timing of any actual infection (probably with no symptoms at all) is unclear.

                (KLD)
                The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

                Comment


                • #9
                  thanks for the reply. She lived in st. louis for 5 years then jacksonville florida so maybe that is a positive. It sounds like there are alot of questions still out there about MS. I am hopeful that when she fell it either whiplashed her neck or the jar effect of impact and that she will fully recover but the saying is plan for the worst hope for the best. I hope your mother is doing well.

                  Comment


                  • #10
                    ok today i am reading the MRI results focal area of increased signal within left lateral margin of the cervical cord extending from the mid body of c3 to the mid body of c4. This signal is somewhat atypical for a cord contusion. No prevertebral swelling. This could represent a demyelinating process. No idea what demyelinating process is. The way it was explained to me is basically exposed nerves the sheathing is deteriorated.

                    Comment


                    • #11
                      Originally posted by wpm View Post
                      No idea what demyelinating process is. The way it was explained to me is basically exposed nerves the sheathing is deteriorated.
                      As a practical matter, that is accurate - a demyelinated nerve is often compared with an electrical wire with damaged or missing insulation. A "demyelinating process" refers to any condition that results in demyelination of nerves in the brain and/or spinal cord, including - but not limited to - MS.

                      There are many, many neurological conditions that can cause demyelinating lesions (also known as "plaques"), and a variety of tests are performed in order to narrow the field. Diagnosis can be made quickly in some cases, but often it takes a long time and the diagnostic process can be quite frustrating. Your wife has a demyelinating lesion identified on MRI, but that finding is one piece of a puzzle that must include clinical examination, medical history and tests to rule out so-called "MS mimics."

                      If you haven't already discovered it, the National MS Society has a very informative website. You might also like to read through some of the threads on the Tranverse Myelitis, Multiple Sclerosis, Non-Traumatic SCI forum here at CareCure. You might not find specific answers to your questions on the forum threads, but they will give you a sense of what people experience as they deal with these issues.

                      It's very important that you find a neurologist in whom you have confidence; don't hesitate to get second opinions, and ask the doctor(s) a lot of questions based on your research, because while different neurological conditions tend to have characteristic presentations, each person's experience bears its own stamp.
                      MS with cervical and thoracic cord lesions

                      Comment


                      • #12
                        Originally posted by wpm View Post
                        My wife has numbness to temperature on complete left side of her body except head and on the right side her arm has limited motion with weakness especially the further she extends her arm. She is 31 years old with no prior anything or family history she did fall about 5 feet the week before but had no soreness or bruising and was fine all week. Since the night this has came on we have been to the ER with xrays and cat scans that showed nothing so they recommended orthopedics which had MRI done of whole spinal cord it showed c3 and c4 brighter than the rest of spinal cord. The orthopedic said it could be a contusion or the outer sheathing damaged with the nerves exposed but said he doesn't know so he is sending us to an neurologist and it sounds like we may be doing a brain MRI next. I am not sure what i am expecting writing this just thought i would share and see what you'll thoughts we're. I can't sleep anyway to worried about the wife. I do work 2 full time jobs and have 2 kids one of them 1 year old so it may take me time in between writings thanks
                        wpm,

                        I am sorry that I did not see your post until just now. Based on your description alone, it does not sound like multiple sclerosis (MS). The MRI shows increased signal intensity around C3/C4. This suggets a contusion, transverse myelitis (TM), or stroke of the spinal cord. The fact your wife had a 5-foot fall the previous week may or may not have been the cause because, as you pointed out, she seemed to have been fine for a week afterward. If there were a hematoma pressing on the spinal cord, that would have been seen on the MRI.

                        The neurological changes that you describe are consistent of a Brown-Secquard Syndrome. This term is used to refer to the neurological symptoms that are associated with a injury to one side of the spinal cord. Normally, the pain and temperature fibers cross over in the spinal cord shortly after they enter the cord and ascend on the other side of the cord. The motor tracts travel down the spinal cord on the same side. It sounds like she had a right sided injury that at C3/4 that is causing her arm weakness and loss of temperature sensation on the left side of her body.

                        The fact that you are not describing weakness of her right leg suggests that she has not only a Brown-Secquard but also a central cord syndrome. This is a syndrome from the arms are paradoxically affected more than the legs. A central cord syndrome results from an injury to the lateral column of the spinal cord. I have described both of these syndromes elsewhere on this site. The fact that neurological symptoms are so localized suggests that your wife had an injury to the right spinal cord at C4.

                        Her prognosis should be good. A vast majority of people who have central cord syndrome or Brown-Secquard syndrome recover both arms and legs. Some residual sensory dysfunction and motor weakness may remain for a year or more but I believe that she should eventually recover completely from this injury.

                        So, what could have been the cause of her injury? A contusion is probably unlikely although a consequence (such as a hemorrhage or stroke) of the trauma may have caused the problem. If I were her doctor, I would probably try to rule out some other potential causes such as an arteriovenous malformation (AVM), look for inflammatory cells in the cerebrospinal fluid because TM is sometimes associated with inflammation, and ask about a history of a virus infection or vaccination because TM is often associate with having gotten a vaccine or infection. It is possible that she may never find out what the cause of the problem is.

                        She will need rehabilitation, physical and occupational therapy. You should not worry. I think most of the bad stuff has been ruled out by the MRI. For example, she doesn't have a tumor. The injury is one from which she should recover almost completely although it will take time.

                        Wise.

                        Comment


                        • #13
                          Originally posted by Bonnette View Post
                          As a practical matter, that is accurate - a demyelinated nerve is often compared with an electrical wire with damaged or missing insulation. A "demyelinating process" refers to any condition that results in demyelination of nerves in the brain and/or spinal cord, including - but not limited to - MS.

                          There are many, many neurological conditions that can cause demyelinating lesions (also known as "plaques"), and a variety of tests are performed in order to narrow the field. Diagnosis can be made quickly in some cases, but often it takes a long time and the diagnostic process can be quite frustrating. Your wife has a demyelinating lesion identified on MRI, but that finding is one piece of a puzzle that must include clinical examination, medical history and tests to rule out so-called "MS mimics."

                          If you haven't already discovered it, the National MS Society has a very informative website. You might also like to read through some of the threads on the Tranverse Myelitis, Multiple Sclerosis, Non-Traumatic SCI forum here at CareCure. You might not find specific answers to your questions on the forum threads, but they will give you a sense of what people experience as they deal with these issues.

                          It's very important that you find a neurologist in whom you have confidence; don't hesitate to get second opinions, and ask the doctor(s) a lot of questions based on your research, because while different neurological conditions tend to have characteristic presentations, each person's experience bears its own stamp.

                          Thank You

                          Comment


                          • #14
                            Originally posted by Wise Young View Post
                            wpm,

                            I am sorry that I did not see your post until just now. Based on your description alone, it does not sound like multiple sclerosis (MS). The MRI shows increased signal intensity around C3/C4. This suggets a contusion, transverse myelitis (TM), or stroke of the spinal cord. The fact your wife had a 5-foot fall the previous week may or may not have been the cause because, as you pointed out, she seemed to have been fine for a week afterward. If there were a hematoma pressing on the spinal cord, that would have been seen on the MRI.

                            The neurological changes that you describe are consistent of a Brown-Secquard Syndrome. This term is used to refer to the neurological symptoms that are associated with a injury to one side of the spinal cord. Normally, the pain and temperature fibers cross over in the spinal cord shortly after they enter the cord and ascend on the other side of the cord. The motor tracts travel down the spinal cord on the same side. It sounds like she had a right sided injury that at C3/4 that is causing her arm weakness and loss of temperature sensation on the left side of her body.

                            The fact that you are not describing weakness of her right leg suggests that she has not only a Brown-Secquard but also a central cord syndrome. This is a syndrome from the arms are paradoxically affected more than the legs. A central cord syndrome results from an injury to the lateral column of the spinal cord. I have described both of these syndromes elsewhere on this site. The fact that neurological symptoms are so localized suggests that your wife had an injury to the right spinal cord at C4.

                            Her prognosis should be good. A vast majority of people who have central cord syndrome or Brown-Secquard syndrome recover both arms and legs. Some residual sensory dysfunction and motor weakness may remain for a year or more but I believe that she should eventually recover completely from this injury.

                            So, what could have been the cause of her injury? A contusion is probably unlikely although a consequence (such as a hemorrhage or stroke) of the trauma may have caused the problem. If I were her doctor, I would probably try to rule out some other potential causes such as an arteriovenous malformation (AVM), look for inflammatory cells in the cerebrospinal fluid because TM is sometimes associated with inflammation, and ask about a history of a virus infection or vaccination because TM is often associate with having gotten a vaccine or infection. It is possible that she may never find out what the cause of the problem is.

                            She will need rehabilitation, physical and occupational therapy. You should not worry. I think most of the bad stuff has been ruled out by the MRI. For example, she doesn't have a tumor. The injury is one from which she should recover almost completely although it will take time.

                            Wise.
                            Thank You your comments made me and my wife feel better. We will keep everyone informed as we know more.

                            Comment

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