MRI characteristics of suspected acute spinal cord infarction in two cats, and a review of the literature

Abstract

A 10-year-old neutered male Persian cat and a 4-year-old spayed female domestic shorthair (DSH) cat were evaluated for acute-onset severe lateralising tetraparesis and hemiplegia, respectively. Both cats also had left-sided Horner's syndrome. Neurological examination of the cats localised the lesion to cranial to C5 in the Persian and the left cervical intumescence (C6-T2) in the DSH. Physical examinations were otherwise generally unremarkable. Routine laboratory tests and spinal radiography were normal for the Persian cat and were not performed for the DSH cat. A cerebrospinal fluid (CSF) tap was attempted for the Persian cat but aborted because of gross blood contamination, and was not performed for the DSH cat. Magnetic resonance imaging (MRI) of the Persian cat revealed a lesion within the spinal parenchyma at segments C1 to C3 (slightly more left-sided) which was iso- to hypointense on T1-weighted scans and hyperintense on T2-weighted scans, and which enhanced slightly with gadolinium. MRI of the DSH cat revealed a lesion within the spinal parenchyma at segment C7 (predominantly left-sided) which was hypointense on T1-weighted scans and hyperintense on T2-weighted gradient echo scans. Contrast was not administered. The MRI findings in both cases were highly suggestive of acute spinal cord infarction, based upon comparison to human cases. Both cats made full neurological recoveries with supportive treatment only. This paper describes two cases of suspected acute spinal cord infarction in the cat, demonstrates the potential diagnostic value of MRI, and discusses the clinical syndrome of this condition with a brief review of published cases.

Fig 1.

A sagittal T2-weighted MR image of the cervical spinal cord of case 1. There is a poorly delineated but extensive intraparenchymal hyperintensity noted in the cervical spinal cord over the level of vertebral bodies C1 to C3 (arrow). TR=1806 ms, TE=130 ms.

Fig 2.

A transverse T2-weighted MR image of the cervical spinal cord of case 1 at the level of C2 vertebral body. There is a lateralised hyperintense lesion noted within the spinal cord (arrow). TR=3000 ms, TE=100 ms.

Fig 3.

A sagittal T2-weighted MR image of the cervical spinal cord of case 2. There is extensive dorsal parenchymal hyperintensity noted over the seventh cervical to the second thoracic vertebrae (arrow). TR=3500 ms, TE=112 ms.

Fig 4.

A transverse T2-weighted gradient echo MR image of the spinal cord of case 2 at the level of the seventh cervical vertebra. There is irregular asymmetrical hyperintensity within the parenchyma of the spinal cord (arrows). TR=630 ms, TE=22 ms.