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Renzo Manara, MD; Franco Schiavon, MD; Valeria Carraro, MD; Annachiara Cagnin, MD; Chiara Briani, MD

Arch Neurol. 2009;66(4):532-533.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

A 43-year-old woman presented with progressive left visual loss, gait impairment, and urinary incontinence. Examination revealed paraparetic gait, pyramidal deep tendon reflexes, and bilateral Babinski sign. Her erythrocyte sedimentation rate was raised. Extensive diagnostic workup (including measurement of antinuclear antibody, extractable nuclear antigen, antineutrophil cytoplasmic antibody, antiphospholipid antibodies, angiotensin-converting enzyme, and antibodies to aquaporin-4) ruled out systemic or infectious vasculitis. The results of cerebrospinal fluid biochemical and microbiological analysis were negative. Oligoclonal bands were absent. Spinal magnetic resonance imaging (MRI) disclosed a cervicodorsal T2-hyperintense lesion with cervical tract swelling (Figure, A); brain MRI showed acute ischemic lesions in watershed areas of the left centrum semiovale (Figure, B). Magnetic resonance angiography revealed bilateral middle cerebral artery occlusion. Catheter angiography confirmed these findings (Figure, C) and evidenced narrowing of the left . . . [Full Text of this Article]

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