Is Peripheral Spinal Cord Hypointensity a Sign of Venous Hypertensive Myelopathy?
To describe a heretofore unnoticed finding, specific to a particular diagnosis, has always been a challenge for radiologists. When validated over time by different observers, these “signs” become part of the language of our specialty. Radiology is replete with such signs because they may render an otherwise difficult diagnosis easier, may help one appreciate the anatomy and pathologic features of an underlying abnormality, and most importantly, may quickly direct the treating physician to the proper diagnosis. In this issue of the AJNR (page 781), Hurst and Grossman posit that peripheral hypointensity of the spinal cord on T2-weighted images suggests the presence of a venous hypertensive myelopathy, and imply that with this “sign” one should consider the possibility of an underlying spinal dural arteriovenous fistula (SDAVF). That conclusion and their article deserves comment. The diagnosis and treatment of SDAVFs have received considerable attention in the literature over the past few
