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Case Reports in Neurological Medicine
Volume 2013, Article ID 159649, 5 pages
Case Report

Subacute Combined Degeneration of the Spinal Cord due to Different Etiologies and Improvement of MRI Findings

Department of Neurology, Medical Faculty, Bezmialem Vakıf University, Turkey

Received 4 February 2013; Accepted 10 March 2013

Academic Editors: P. Berlit, C.-C. Huang, and M. Swash

Copyright © 2013 Azize Esra Gürsoy et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Subacute combined degeneration (SCD) is a rare neurological complication of vitamin B12 deficiency, characterized by demyelination of the dorsal and lateral spinal cord. Herein, we describe three cases, who presented with SCD, one related to reduced intake of vitamin B12 because of a vegetarian diet and two related to nitrous oxide exposure during surgery. MR images of our patients revealed symmetrical hyperintense signals in dorsal and lateral columns in T2 weighted series. After treatment with intramuscular B12 injections (1 mg daily for 2 weeks, once weekly thereafter for three months) all patients showed improvement of their symptoms. Abnormalities of the spinal cord on MRI resolved in three months. In conclusion, SCD either due to nitrous oxide exposure or due to reduced intake of vitamin B12 is a reversible condition, when detected and treated early.