Abstract

A CASE STUDY ON A COMPREHENSIVE REVIEW OF HIRAYAMA DISEASE

Mr. M. Suriya^*, Dr. C. Jothimanivannan, Mr. S. Rabiniraj, Mr. P. Jothiprakash, Mr. G. Ranish

Abstract

Adolescent boys are the main victims of Hirayama disease (HD), a rare, self-limiting cervical myelopathy that manifests as gradual, asymmetric weakening and atrophy of the distal upper limb. The condition is caused by anterior displacement of the posterior dura mater, which compresses the spinal cord dynamically during neck flexion. HD stabilises following an initial active phase, in contrast to progressive motor neurone disorders. Flexion MRI, which shows distinctive dural changes and venous congestion, is the key to the diagnosis. Permanent spinal cord injury can be avoided with early cervical immobilisation treatments. Surgical procedures such as anterior cervical decompression and fusion may be useful in situations that are progressing or refractory. The pathophysiology, clinical presentation, imaging, differential diagnosis, and therapeutic approaches of HD are all summarised in this study. For prompt diagnosis and better outcomes, greater worldwide awareness and sophisticated imaging are crucial.

Keywords: cervical myelopathy, flexion MRI, motor neuron disorder, distal upper limb weakness, dynamic spinal cord compression, adolescent males, cervical collar.