Acute Transverse Myelopathy

Acute transverse myelopathy (myelitis) is a monophasic, acute inflammatory process involving both the dorsal and ventral halves of the spinal cord. Patients present with paraplegia, sensory impairment at a specific spinal level, and sphincter dysfunction.

Acute transverse myelopathy can be idiopathic or be caused by:

• Multiple scleorosis:
• Viral infection:
• Acute disseminated encephalomyelitis:
• Collagen vascular disorders: Systemic lupus erythematosis
• Vascular disorders:
• Paraneoplastic syndromes:

On MRI, there is a T2-hyperintense area that involves > 2/3 of the transverse area of the cord and usually extends for 3-4 spinal segments, usually in the thoracic cord. The cord may or may not be expanded. Enhancement may be diffuse, patchy, or peripheral.

Radiology

• Choi KH, Lee KS, Chung SO, Park JM, Kim YJ, Kim HS, Shinn KS. Idiopathic transverse myelitis: MR characteristics. AJNR Am J Neuroradiol. 1996 Jun-Jul;17(6):1151-60.
• DeSanto J, Ross JS. Spine infection/inflammation. Radiol Clin North Am. 2011 Jan;49(1):105-27.