A RARE CASE OF ACUTE QUADRIPARESIS IN YOUNG ADULT - ROLE OF DIFFUSION-WEIGHTED MR IMAGING

Received 2024-01-13; Accepted 2024-04-02; Published 2024-10-15

Abstract

We present a case of a young adult without any comorbidities who presented with acute quadriparesis. There was a diagnostic dilemma of the case whereby the primary team had difficulties to come up with a diagnosis due to lack of supportive information from the clinical history and limited laboratory investigation results prior to neuroimaging. Purely based on the clinical signs and symptoms, the patient was initially treated for transverse myelitis. Initial imaging performed includes computed tomography (CT) of the brain which did not show any abnormalities. Subsequent magnetic resonance imaging (MRI) of the brain showed no supratentorial abnormalities however there was restricted diffusion at medulla noted in the diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) map. MRI of the cervical spine showed high signal intensity on T2-weighted images in the anterior part of the spinal cord on standard MRI spine sequences. The restricted diffusion detected on DWI and ADC map aids in the diagnosis of spinal cord infarction (SCI) in this patient. However, it is to be noted that the DWI sequence of the MRI spine study is not routinely performed. This case report illustrates the role of DWI in diagnosing SCI in a young adult with quadriparesis.