Findings:
There are increased intramedullary spinal cord signals, predominantly involving the central grey matter and the anterior horns bilaterally, from C6 down to T1 on T2-weighted and STIR sequences. The abnormal intramedullary signals exhibit an owl’s eye appearance. There is some degree of spinal cord expansion, more prominent on the left side.
No further intramedullary lesions could be identified.
The craniocervical junction is normal.
The vertebral bodies and discs are of normal height with no malalignment. The marrow and disc signal is normal.
The central canal, lateral recesses and neural exit foramina are widely patent.
Physiological amount of free fluid is seen in the Douglas pouch. No paravertebral abnormality is identified.
Conclusion:
Multisegment intramedullary lesion involving the anterior spinal cord at C6 to T1 levels, with mild cord oedema, suspicious of acute anterior spinal cord ischaemia. Differential diagnosis include chronic demyelination and transverse myelitis, which given the clinical settings are less likely.
Completion of neuroimaging with contrast enhanced MRI and cardiovascular evaluation is advised.