Skip to main content
SpringerLink
Log in

Flexion-induced cervical myelopathy associated with fewer elastic fibers and thickening in the posterior dura mater

  • Letter to the editors
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Abstract

Two patients with a condition clinically resembling juvenile muscular atrophy of distal upper extremity (Hirayama disease) showed forward protrusive movement of the posterior cervical dura matter during neck flexion. The dura displacement was characteristically limited in an approximately central portion of the posterior dura, which is different from Hirayama disease, which exhibits whole posterior dura displacement. Interestingly, the restricted dura in these patients showed thickening with reduced elastic fibers, indicating that the decreased stretchability of the posterior dura had caused motor dominant cervical myelopathy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

References

  1. Chen CJ, Chen CM, Wu CL, Ro LS, Chen ST, Lee TH (1998) Hirayama disease: MR diagnosis. AJNR Am J Neuroradiol 19:365–368

    CAS  PubMed  Google Scholar 

  2. Hirayama K, Tokumaru Y (2000) Cervical dural sac and spinal cord in juvenile muscular atrophy of distal upper extremity. Neurology 54:1922–1926

    CAS  PubMed  Google Scholar 

  3. Hirayama K, Tomonaga M, Kitano K, Yamada T, Kojima S, Arai K (1987) Focal cervical poliopathy causing juvenile muscular atrophy of distal upper extremity: a pathological study. J Neurol Neurosurg Psychiatry 50:285–290

    Article  CAS  PubMed  Google Scholar 

  4. Pradhan S (2009) Bilaterally symmetric form of Hirayama disease. Neurology 72:2083–2089

    Article  PubMed  Google Scholar 

  5. Pradhan S, Gupta RK (1997) Magnetic resonance imaging in juvenile asymmetric segmental spinal muscular atrophy. J Neuorl Sci 146:133–138

    Article  CAS  Google Scholar 

  6. Reid JD (1960) Effects of flexion–extension movements of the head and spine upon the spinal cord and nerve roots. J Neurol Neurosurg Psychiatry 23:214–221

    Article  CAS  PubMed  Google Scholar 

  7. Willeit J, Kiechl S, Kiechl-Kohlendorfer U, Golaszewski S, Peer S, Poewe W (2001) Juvenile asymmetric segmental spinal muscular atrophy (Hirayama’s disease): three cases without evidence of “flexion myelopathy”. Acta Neurol Scand 104:320–322

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgment

The authors thank Dr. Keizo Hirayama for his invaluable advice and critical review of the paper.

Author information

Authors and Affiliations

  1. Department of Neurology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, Chiba, 260-8670, Japan

    Yasumasa Yoshiyama, Yukio Tokumaru & Kimihito Arai

  2. Department of Neurology, Chiba-East National Hospital, 673 Nitona, Chuo-ku, Chiba, Chiba, 260-8712, Japan

    Yasumasa Yoshiyama & Kimihito Arai

Authors
  1. Yasumasa Yoshiyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yukio Tokumaru
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kimihito Arai
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yasumasa Yoshiyama.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yoshiyama, Y., Tokumaru, Y. & Arai, K. Flexion-induced cervical myelopathy associated with fewer elastic fibers and thickening in the posterior dura mater. J Neurol 257, 149–151 (2010). https://doi.org/10.1007/s00415-009-5329-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00415-009-5329-6

Keywords

Search

Navigation