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A cord enlargement was demonstrated in five cases,whereas four cases presented with medullary atrophy.As demonstrated by MRI,radiation-induced medullary lesions progressed toward cord atrophy in one patient.When MRI and/or comparison myelogram were performed within 8 months following the onset of the myelopathy,a cord enlargement was usually encountered.When the patient was evaluated>8 months after the first neurological symptoms,a cord atrophy was always demonstrated.Medullary lesions extended beyond the boundaries of the radiation field in 67%of the cases.However,with the exception of one case,the main focus of the cord damage was included within an irradiated cord segment.An enlarged cord was often associated with a neurologic deterioration and a fatal outcome.In patients with cord atrophy,the neurologic deficit was often static and survival rates were better.These results suggest a revision of classic criteria used for the diagnosis of CPRM.By demonstrating cord lesions,MRI helps to establish disease prognosis. |
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iatrogenic neurologic disorders
mortality
MRI
MRI,abnormal
MRI,spinal cord
myelomalacia
myelopathy
myelopathy,chronic progressive
myelopathy,radiation induced
prognosis
radiation therapy,CNS treatment and complications with
spinal cord,enlargement
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