Radiation Myelopathy


Clinical features, plus exclusion of other causes

Clinical features:

Recent or distant exposure to radiation
+signs of myelopathy: Lhermitte’s sign, Brown-Sequard lesion is classic
Acute or insidious onset. Transient & progressive forms

Findings on Investigations:


  • Radiation change in the vertebra; increased signal
  • Normal initially
  • Later: T1 hypointese, T2/FLAIR hyperintense, enhances,

CSF: raised protein
SSEP: spinal conduction velocity block


Spectrum: demyelination, Wallarian degeneration of axons, necrosis
Fibrinoid necrosis of vessels, hemorrhage

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