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. 2017 Mar 16:3:17008.
doi: 10.1038/scsandc.2017.8. eCollection 2017.

Surfer's myelopathy without surfing: a report of two pediatric patients

Ana C Albuja  1 , Sharoon Qaiser  1 , Donita D Lightner  1 , Flavius D Raslau  2 , Muhammad S Zafar  1 , Philip A Bernard  3 , Robert J Baumann  1
Affiliations

Surfer's myelopathy without surfing: a report of two pediatric patients

Ana C Albuja et al. Spinal Cord Ser Cases. .

Abstract

Introduction: Surfer's myelopathy (SM) is a rare disorder described in subjects presenting with acute paraparesis while learning how to surf. It is thought to be secondary to spinal ischemia triggered by hyperextension. Spinal magnetic resonance imaging (MRI) shows changes consistent with spinal cord ischemia on T2-weighted and diffusion-weighted imaging (DWI).

Case presentation: We report two patients who presented with acute onset paraplegia shortly after spinal hyperextension. They had no physical or radiological evidence of soft tissue injury. Their clinical and imaging findings closely resemble those described in SM.

Discussion: We propose the use of the term 'acute hyperextension myelopathy' to categorize patients with spinal cord infarction secondary to hyperextension. DWI sequencing on MRI should be considered to evaluate for early signs of spinal cord ischemia in these patients. Use of a broader term for diagnostic classification can help include patients with spinal cord infarction due to a common mechanism.

Keywords: Paediatric neurological disorders; Spinal cord diseases.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Case 1. Cord Infarction. Initial MRI (bottom row) and 4-day follow-up (top row) demonstrating cord edema and swelling in the ventral cord (arrows) and corresponding restricted diffusion (asterisks). MR images include sagittal short inversion time inversion recovery (STIR), sagittal B-800 DWI with apparent diffusion coefficient (ADC) and axial T2W turbo spin echo (TSE) sequences.
Figure 2
Figure 2
Case 2. Cord Infarction. Images demonstrate multifocal T2 hyperintense lesions, most conspicuously in the left lateral cord at T5-6 and right lateral cord at T7 (arrows) with corresponding restricted diffusion (asterisks). These slice positions highlight T5–6 level (top row) and T7 level (bottom row). MR images include sagittal short inversion time inversion recovery (STIR), sagittal B-1000 DWI and apparent diffusion coefficient (ADC), and axial T2W turbo spin echo (TSE) sequences.
See this image and copyright information in PMC

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