Analysis of Missed Diagnosis of Superficial Siderosis of the Central Nervous System on MRI Manifested as Inability of the Lower Extremity

JIA Shu-min; LI Feng-ju; GONG Qing-ge-le; XU Ya-ming

doi:10.3969/j.issn.1002-3429.2018.05.006

Abstract：Objective To enhance the clinicians'understanding of superficial siderosis of the central nervous system(SSCNS),to familiarize MRI manifestations,and to reduce the clinical misdiagnosis. Methods Clinical da-ta of one patient with SSCNS that had been missed by MRI was analyzed retrospectively. Results A 52-year-old fe-male presented to our department because of progressive weakness of the lower limbs for 5 years and inability to walk after aggravation for 1 year. After years of many visits to other hospitals,definitive diagnosis was yet not made by va-rious examinations including head and cervical MRI.After admission to our hospital,head MRI revealed hyperintense on T1WI sequence in bilateral cerebellar vermis,brachium pontis,surface of cerebellar vermis and interhemispheric fissure;two oval mixed hypo and hyperintense on T1WI in cisterna longitudinal fissurae cerebri(suspected cavernous hemangioma);band-like hypointense on T2WI sequence in the bridge brain,cerebellum and the surface of the cere-brum. She was diagnosed as having SSCNS and cavernous hemangioma based on various symptoms,such as progres-sive weakness of double lower limbs, hearing loss of both ears and other neurological damage. After conservative treatment,the patient was discharged in stable condition and followed up for 1 year, reporting excellent recovery. Conclusion SSCNS is a rare syndrome,therefore,MRI magnetic sensitivity weighted imaging is highly sensitive to the diagnosis of the disease. Enhanced understanding of the clinical and imaging manifestations of this disease, as well as early detection of MRI sequences may contribute to early diagnosis and guidance of clinical treatment.