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• Vol.45 No.10
• CLINICA NEUROL, 45: 758−761, 2005
• Vol.45 No.10 contents

Case Report

Gadolinium enhancement of the anterior portion of the lumbosacral roots in a case of post-irradiation lumbosacral radiculopathy

Maiko Umeda, M.D., Satoshi Naruse, M.D., Akiko Ito, M.D. and Nobuya Fujita, M.D.

Department of Neurology, Nagaoka Red Cross Hospital

A 35-year-old woman, who underwent the removal of her uterus as a result of treatment for cancer of the cervix, developed weakness in the distal lower limbs after 8 months of subsequent radiation therapy. Although she could not walk because of distal dominant weakness and atrophy in the legs, no sensory disturbances were observed. An MRI scan showed gadolinium enhancement of the anterior portion of the lumbosacral roots in the cauda equina, which corresponded to her neurological symptoms. The administration of corticosteroid and warfarin dramatically alleviated her neurological symptoms, and a follow-up MRI scan one month later demonstrated a marked diminution of the gadolinium enhancement. There were only seven reports describing the abnormalities of the MRI findings, all of which noted the gadolinium enhancement of the anterior portion of the lumbosacral roots. Together with the findings in other reports, the enhancement abnormalities seem to be characteristic of post-irradiation lumbosacral radiculopathy.

(CLINICA NEUROL, 45: 758−761, 2005)
key words: post-irradiation myelopathy, lumbosacral radiculopathy, MRI, corticosteroid, anticoagulation

(Received: 29-Mar-05)