Diagnostic approach to acute transverse myelopathy, compressive versus non-compressive from for mbbs in short

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Diagnostic Approach to Acute Transverse Myelopathy: Compressive vs. Non-Compressive

(For MBBS - based on Harrison's Principles of Internal Medicine 22E, Localization in Clinical Neurology 8E)

What is Acute Transverse Myelopathy?

A syndrome of acute/subacute bilateral motor, sensory, and autonomic dysfunction at a discrete spinal cord level, producing:
  • Paraplegia or quadriplegia
  • Sensory level below the lesion
  • Bladder/bowel/sphincter dysfunction

STEP 1 - Clinical Recognition (Cord Syndrome)

Three cardinal features point to spinal cord pathology:
FeatureDetails
MotorWeakness/paralysis below lesion; initially flaccid (spinal shock), later spastic (UMN signs)
SensoryAll modalities lost below a sensory level; pin-prick loss most valuable to localize
AutonomicUrinary retention, loss of bowel control, erectile dysfunction
Tip: With extramedullary lesions, the sensory level may be found several segments below the actual lesion level (due to somatotopic organization of the spinothalamic tract - sacral fibers are most superficial/lateral).

STEP 2 - Determine the Level

LevelClinical Clue
CervicalQuadriplegia + C3-C5 involvement may cause respiratory failure
Thoracic (most common)Paraplegia; thoracic back pain
Conus medullarisMixed UMN + LMN; early sphincter involvement
Cauda equina (not cord)Pure LMN; radicular pain; saddle anesthesia

STEP 3 - The Priority: Compressive vs. Non-Compressive

"The first priority is to exclude treatable compression of the cord by a mass lesion." - Harrison's 22E

COMPRESSIVE MYELOPATHY

Causes (mnemonic: TEHSD)

  • Tumor - spinal metastases (breast, lung, prostate, kidney, lymphoma, myeloma) - most common in adults; usually epidural
  • Epidural abscess - fever + back pain + neurological deficit triad
  • Hemorrhage - epidural or subdural hematoma (anticoagulants, trauma, AVM)
  • Spondylosis / disk herniation - chronic > acute; cervical most common
  • Subluxation/trauma

Clinical Clues Favoring Compression

  • Gradual onset with a history of neck or back pain
  • Nocturnal pain worsening with recumbency (malignancy sign)
  • Pain worsened by coughing, sneezing, movement
  • Radicular pain (shooting/radiating from spine) at the level of compression
  • Localized vertebral tenderness on percussion
  • History of known malignancy, immunocompromise (abscess), or anticoagulation (hematoma)
  • UMN signs - spasticity, hyperreflexia, upgoing plantars (Babinski) BELOW the level

NON-COMPRESSIVE MYELOPATHY

Causes (mnemonic: VAID-P)

CategoryExamples
Vascular / IschemicAnterior spinal artery infarction (aortic disease, hypotension, surgery)
Autoimmune / DemyelinatingMultiple sclerosis (MS), Neuromyelitis optica spectrum disorder (NMOSD), MOG-antibody disease
Inflammatory / IdiopathicAcute transverse myelitis (idiopathic), sarcoidosis, SLE, Sjogren's
Demyelinating - Post-infectiousAcute Disseminated Encephalomyelitis (ADEM)
Parainfectious / InfectiousHSV, VZV, CMV, EBV, enteroviruses, HIV, HTLV-1, schistosomiasis

Clinical Clues Favoring Non-Compressive

  • Sudden/very rapid onset (minutes to hours) - suggests ischemia
  • Preceding fever, infection, vaccination - suggests post-infectious/parainfectious
  • Young woman + optic neuritis - strongly suggests MS or NMOSD
  • No vertebral pain or bony tenderness
  • History of autoimmune disease (SLE, Sjogren's)

STEP 4 - Investigations

First-line (Emergency):

MRI spine with gadolinium - the MOST IMPORTANT investigation
  • Centers on clinically suspected level
  • Image entire spine (cervical through sacral) - up to 40% have silent lesions elsewhere
  • Do NOT delay for spinal compression if clinically suspected
MRI FeatureSuggests
Epidural mass, cord compression, loss of CSF signal around cordCompressive
Intramedullary T2 hyperintensity, cord swelling, enhancementInflammatory/demyelinating
"Pencil sign" - longitudinal anterior T2 bright signal + diffusion restrictionCord ischemia (anterior spinal artery)
"Owl's eyes" - bilateral anterior horn T2 signal on axial viewCord infarction
Short T2 lesion (<2 vertebral segments)Suggests MS
Long T2 lesion (>3 vertebral segments, LETM)Suggests NMOSD, sarcoid, ischemia

If MRI Normal or Non-Compressive Found - Second-line:

TestPurpose
CSF analysisPleocytosis + elevated protein = inflammatory/infectious; oligoclonal bands = MS
AQP4-IgG (anti-NMO antibody)NMOSD diagnosis
MOG-IgG antibodyMOG-antibody disease
CRMP5, amphiphysin IgGParaneoplastic myelopathy
ANA, dsDNA, ANCA, ENASLE, Sjogren's, vasculitis
Viral PCR (HSV, VZV, CMV, EBV, HIV, HTLV-1)Infectious myelitis
ESR, CRP, culturesEpidural abscess
Vit B12, folateSubacute combined degeneration (if chronic)
VDRL/RPRNeurosyphilis
Chest X-ray + ACE levelSarcoidosis

STEP 5 - Diagnostic Algorithm (Summary)

Acute onset of bilateral motor + sensory + autonomic deficit
              ↓
     MRI SPINE WITH GADOLINIUM (URGENT)
              ↓
    ┌─────────────────────────────────┐
    ▼                                 ▼
COMPRESSION SEEN              NO COMPRESSION
(epidural mass/abscess)        (intramedullary signal)
    ↓                                 ↓
EMERGENCY                    ┌────────────────┐
DECOMPRESSION                ▼                ▼
(surgery ±                Vascular?      Inflammatory?
steroids/antibiotics)    (sudden onset,   (subacute,
                         aortic dz)       young, CSF)
                              ↓                ↓
                         Supportive      CSF + antibody
                         care            panel (AQP4,
                                         MOG, ANA, viral PCR)

Key Differentiating Points at a Glance

FeatureCompressiveNon-Compressive
OnsetSubacute/gradualSudden (ischemia) or subacute (inflammatory)
PainVertebral/radicular, mechanicalMidline/absent (inflammatory)
FeverPresent (abscess)May be present (post-infectious)
ProgressionHours to daysMinutes (vascular) to days (inflammatory)
MRIEpidural mass, cord compressionIntramedullary T2 signal change
CSFOften normalPleocytosis (inflammatory), normal (ischemia)
TreatmentSurgery/antibiotics (URGENT)Steroids, plasma exchange, antivirals

Specific Entity - Acute Transverse Myelitis (ATM)

Idiopathic ATM is a diagnosis of exclusion. Criteria require:
  1. Bilateral motor/sensory/autonomic dysfunction
  2. Clearly defined sensory level
  3. Evidence of spinal cord inflammation (CSF pleocytosis OR MRI gadolinium enhancement)
  4. Peak deficits within 4 hours to 21 days
  5. Exclusion of compressive, vascular, and other causes

Sources: Harrison's Principles of Internal Medicine 22E, p. 3607-3608; Localization in Clinical Neurology 8E, p. 255

Generate a diagnostic flowchart poster for exam prep

Generating Image

A medical diagnostic flowchart poster for MBBS exam prep titled "Acute Transverse Myelopathy: Diagnostic Approach". Clean clinical style with white background. The flowchart starts at the top with a blue header box: "ACUTE TRANSVERSE MYELOPATHY" with subtitle "Motor + Sensory + Autonomic deficit below a spinal level" Below it, three symptom boxes in a row connected by lines: - Green box: "MOTOR: Weakness/Paralysis (flaccid→spastic)" - Yellow box: "SENSORY: Sensory level (pin-prick most useful)" - Orange box: "AUTONOMIC: Bladder retention, Bowel dysfunction" Arrow pointing down to a large red urgent box: "URGENT MRI SPINE WITH GADOLINIUM (Image entire spine: C to S)" From this MRI box, two branches with arrows going left and right: LEFT BRANCH (red/orange box): "COMPRESSION SEEN" - Epidural mass/tumor - Epidural abscess - Hematoma - Herniated disc - Spondylosis Below it: "CLINICAL CLUES: Back/neck pain (worse at night), Radicular pain, Known malignancy, Fever+immunocompromise, Anticoagulation use" Below: RED EMERGENCY box: "EMERGENCY DECOMPRESSION Surgery ± Steroids/Antibiotics" RIGHT BRANCH (blue/green box): "NO COMPRESSION (Intramedullary signal)" Split into two sub-branches: Sub-branch 1 (purple): "VASCULAR (Anterior spinal artery)" - Sudden onset (minutes) - MRI: Pencil sign, Owl's eyes - Aortic disease/surgery - Treatment: Supportive Sub-branch 2 (teal): "INFLAMMATORY / INFECTIOUS" - Subacute onset (hours-days) - Young patient, post-infection - Long T2 lesion (LETM = NMOSD) - Short lesion = MS Below: "CSF + ANTIBODY PANEL: AQP4-IgG (NMOSD), MOG-IgG, ANA/dsDNA (SLE), Viral PCR (HSV,VZV,HIV), CRMP5 (paraneoplastic)" Treatment: "Steroids / PLEX / Antivirals" At the bottom, a summary comparison table with two columns: Left: COMPRESSIVE | Right: NON-COMPRESSIVE Row 1: Onset - Subacute/gradual | Sudden or subacute Row 2: Pain - Vertebral/radicular | Absent or midline Row 3: MRI - Epidural mass | Intramedullary T2 signal Row 4: CSF - Often normal | Pleocytosis (inflammatory) Row 5: Tx - Surgery/Antibiotics URGENT | Steroids/PLEX/Antivirals Footer: "Harrison's 22E | For MBBS Exam Prep" Use color coding: red for emergency/compressive, blue for non-compressive/vascular, teal for inflammatory, clear arrows and connecting lines, professional medical poster layout

Running Command

mkdir -p /tmp/workspace/myelopathy-poster && ls /tmp/workspace/

Writing File

~/myelopathy-poster/generate_poster.py

import matplotlib
matplotlib.use('Agg')
import matplotlib.pyplot as plt
import matplotlib.patches as mpatches
from matplotlib.patches import FancyBboxPatch, FancyArrowPatch

fig, ax = plt.subplots(figsize=(20, 28))
ax.set_xlim(0, 20)
ax.set_ylim(0, 28)
ax.axis('off')
fig.patch.set_facecolor('#F7F9FC')
ax.set_facecolor('#F7F9FC')

# ─── Helper functions ───────────────────────────────────────────────

def rounded_box(ax, x, y, w, h, color, text, fontsize=10, text_color='white',
                bold=False, alpha=1.0, radius=0.3, ha='center', va='center',
                wrap_width=None, lineheight=1.4):
    box = FancyBboxPatch((x, y), w, h,
                         boxstyle=f"round,pad=0.0,rounding_size={radius}",
                         linewidth=1.5, edgecolor='white',
                         facecolor=color, alpha=alpha, zorder=3)
    ax.add_patch(box)
    weight = 'bold' if bold else 'normal'
    ax.text(x + w/2, y + h/2, text, ha=ha, va=va,
            fontsize=fontsize, color=text_color, weight=weight,
            zorder=4, linespacing=lineheight,
            multialignment='center')

def arrow(ax, x1, y1, x2, y2, color='#555555', lw=2):
    ax.annotate('', xy=(x2, y2), xytext=(x1, y1),
                arrowprops=dict(arrowstyle='->', color=color,
                                lw=lw, connectionstyle='arc3,rad=0.0'),
                zorder=5)

def line(ax, x1, y1, x2, y2, color='#AAAAAA', lw=1.5):
    ax.plot([x1, x2], [y1, y2], color=color, lw=lw, zorder=2)

# ─── COLORS ─────────────────────────────────────────────────────────
C_HEADER   = '#1A237E'   # deep navy
C_SYMPTOM  = '#1565C0'   # blue
C_URGENT   = '#B71C1C'   # dark red
C_COMPRESS = '#C62828'   # red
C_COMPRESS2= '#EF5350'   # lighter red
C_VASCULAR = '#6A1B9A'   # purple
C_INFLAM   = '#00695C'   # teal
C_COMPARE  = '#263238'   # dark slate
C_FOOT     = '#37474F'
C_ARROW    = '#37474F'
C_LIGHT    = '#FFEBEE'
C_LBLUE    = '#E3F2FD'
C_LTEAL    = '#E0F2F1'
C_LPURP    = '#F3E5F5'

# ══════════════════════════════════════════════════════
# ROW 1 — MAIN TITLE  (y=26.0)
# ══════════════════════════════════════════════════════
rounded_box(ax, 1, 26.1, 18, 1.6, C_HEADER,
            'ACUTE TRANSVERSE MYELOPATHY\nDiagnostic Approach: Compressive vs Non-Compressive',
            fontsize=17, bold=True, radius=0.4, lineheight=1.5)

# ══════════════════════════════════════════════════════
# ROW 2 — THREE SYMPTOM BOXES  (y=24.0)
# ══════════════════════════════════════════════════════
arrow(ax, 10, 26.1, 10, 25.25, C_ARROW, lw=2)

sx, sy, sw, sh = 1.0, 23.3, 5.5, 1.6
rounded_box(ax, sx, sy, sw, sh, '#1565C0',
            'MOTOR\nWeakness / Paralysis\nFlaccid → Spastic (UMN)',
            fontsize=9.5, radius=0.3, lineheight=1.5)

rounded_box(ax, 7.25, sy, sw, sh, '#E65100',
            'SENSORY\nSensory level below lesion\nPin-prick most useful',
            fontsize=9.5, radius=0.3, lineheight=1.5)

rounded_box(ax, 13.5, sy, sw, sh, '#2E7D32',
            'AUTONOMIC\nUrinary retention\nBowel / Sphincter dysfunction',
            fontsize=9.5, radius=0.3, lineheight=1.5)

# ══════════════════════════════════════════════════════
# ROW 3 — URGENT MRI BOX  (y=21.3)
# ══════════════════════════════════════════════════════
arrow(ax, 10, 23.3, 10, 22.6, C_ARROW, lw=2)

rounded_box(ax, 3, 21.0, 14, 1.5, C_URGENT,
            '⚡  URGENT: MRI SPINE WITH GADOLINIUM\n'
            'Image entire spine (Cervical → Sacral)  |  First investigation',
            fontsize=12, bold=True, radius=0.4, lineheight=1.5)

# ══════════════════════════════════════════════════════
# BRANCH LINES from MRI box
# ══════════════════════════════════════════════════════
# horizontal bar
line(ax, 5.0, 21.0, 5.0, 20.3, C_COMPRESS, lw=2.5)
line(ax, 15.0, 21.0, 15.0, 20.3, C_INFLAM, lw=2.5)
line(ax, 5.0, 20.3, 15.0, 20.3, '#888888', lw=2)

arrow(ax, 5.0,  20.3, 5.0,  19.7, C_COMPRESS, lw=2.5)
arrow(ax, 15.0, 20.3, 15.0, 19.7, C_INFLAM,   lw=2.5)

# ══════════════════════════════════════════════════════
# LEFT BRANCH — COMPRESSIVE  (x=0.5..9.5)
# ══════════════════════════════════════════════════════

# Header
rounded_box(ax, 0.5, 18.8, 9.0, 0.85, C_COMPRESS,
            'COMPRESSION SEEN',
            fontsize=12, bold=True, radius=0.3)

# Causes box
causes_txt = (
    'Causes (TEHSD):\n'
    '• Tumor – spinal metastases (breast, lung, prostate)\n'
    '• Epidural Abscess (fever + back pain + deficit)\n'
    '• Hemorrhage – epidural/subdural hematoma\n'
    '• Spondylosis / Herniated disc\n'
    '• Subluxation / Trauma'
)
rounded_box(ax, 0.5, 16.3, 9.0, 2.35, C_LIGHT,
            causes_txt, fontsize=8.5, text_color='#B71C1C',
            radius=0.3, lineheight=1.5)

# Clues box
clues_txt = (
    'Clinical Clues:\n'
    '• Back/neck pain, worse at night or with movement\n'
    '• Radicular / radiating pain\n'
    '• Known malignancy\n'
    '• Fever + immunocompromise\n'
    '• Anticoagulation use\n'
    '• Vertebral tenderness on percussion'
)
rounded_box(ax, 0.5, 13.7, 9.0, 2.45, '#FFCDD2',
            clues_txt, fontsize=8.5, text_color='#7B1FA2',
            radius=0.3, lineheight=1.5)

arrow(ax, 5.0, 13.7, 5.0, 13.0, C_COMPRESS, lw=2.5)

# Treatment box
rounded_box(ax, 0.5, 11.8, 9.0, 1.1, C_COMPRESS,
            '🚨  EMERGENCY DECOMPRESSION\n'
            'Surgery  ±  Steroids / Antibiotics (abscess)',
            fontsize=9.5, bold=True, radius=0.35, lineheight=1.5)

# ══════════════════════════════════════════════════════
# RIGHT BRANCH — NON-COMPRESSIVE  (x=10.5..19.5)
# ══════════════════════════════════════════════════════

rounded_box(ax, 10.5, 18.8, 9.0, 0.85, C_INFLAM,
            'NO COMPRESSION (Intramedullary Signal)',
            fontsize=12, bold=True, radius=0.3)

# Sub-branch split
line(ax, 13.0, 18.8, 13.0, 18.3, C_VASCULAR, lw=2)
line(ax, 18.0, 18.8, 18.0, 18.3, C_INFLAM,   lw=2)
line(ax, 13.0, 18.3, 18.0, 18.3, '#888888',   lw=1.5)
arrow(ax, 13.0, 18.3, 13.0, 17.85, C_VASCULAR, lw=2)
arrow(ax, 18.0, 18.3, 18.0, 17.85, C_INFLAM,   lw=2)

# VASCULAR sub-box
rounded_box(ax, 10.5, 16.0, 4.0, 0.75, C_VASCULAR,
            'VASCULAR', fontsize=9, bold=True, radius=0.25)

vasc_txt = (
    'Anterior Spinal Artery\n'
    '• Sudden onset (mins-hrs)\n'
    '• Sharp midline back pain\n'
    '• Anterior cord syndrome\n'
    '  (motor loss + pain/temp loss,\n'
    '   vibration SPARED)\n'
    'MRI: Pencil sign, Owl\'s eyes\n'
    'Causes: aortic disease/surgery,\n'
    'hypotension, dissection\n'
    'Rx: Supportive'
)
rounded_box(ax, 10.5, 13.0, 4.0, 2.9, C_LPURP,
            vasc_txt, fontsize=7.8, text_color='#4A148C',
            radius=0.25, lineheight=1.45)

# INFLAMMATORY sub-box
rounded_box(ax, 15.0, 16.0, 4.5, 0.75, C_INFLAM,
            'INFLAMMATORY / INFECTIVE', fontsize=8.5, bold=True, radius=0.25)

inflam_txt = (
    'Causes:\n'
    '• MS – short lesion (<2 seg)\n'
    '• NMOSD – LETM (>3 seg)\n'
    '  → AQP4-IgG antibody\n'
    '• MOG-antibody disease\n'
    '• Post-infectious / ADEM\n'
    '• SLE, Sjogren\'s, sarcoid\n'
    '• Viral: HSV, VZV, HIV, CMV\n'
    '• HTLV-1 (tropical spastic)\n'
    'Rx: IV Steroids / PLEX\n'
    '     Antivirals (if viral)'
)
rounded_box(ax, 15.0, 13.0, 4.5, 2.9, C_LTEAL,
            inflam_txt, fontsize=7.8, text_color='#004D40',
            radius=0.25, lineheight=1.45)

# ══════════════════════════════════════════════════════
# INVESTIGATIONS PANEL  (y=10.5 .. 12.8)
# ══════════════════════════════════════════════════════
rounded_box(ax, 10.5, 12.0, 9.0, 0.75, '#01579B',
            'INVESTIGATIONS (if Non-Compressive)', fontsize=10, bold=True, radius=0.3)

inv_txt = (
    'Blood: CBC, ESR, CRP  |  ANA, dsDNA, ANCA  |  ACE level  |  Vit B12  |  HIV, HTLV-1, VDRL/RPR\n'
    'CSF: Cell count, protein, glucose  |  Oligoclonal bands (MS)  |  Viral PCR (HSV, VZV, CMV, EBV)\n'
    'Antibodies: AQP4-IgG (NMOSD)  |  MOG-IgG  |  CRMP5, amphiphysin (paraneoplastic)\n'
    'Imaging: CXR (sarcoid/tumor)  |  CT chest (lymphoma)  |  VEPs (MS)'
)
rounded_box(ax, 10.5, 10.3, 9.0, 1.6, C_LBLUE,
            inv_txt, fontsize=8, text_color='#0D47A1',
            radius=0.3, lineheight=1.5)

# ══════════════════════════════════════════════════════
# COMPARISON TABLE  (y=8.0 .. 10.3)
# ══════════════════════════════════════════════════════
arrow(ax, 10, 11.8, 10, 11.1, C_ARROW, lw=1.5)

rounded_box(ax, 1, 10.0, 18, 0.7, C_COMPARE,
            'QUICK COMPARISON: Compressive vs Non-Compressive',
            fontsize=10.5, bold=True, radius=0.3)

# Table headers
rounded_box(ax, 1.0,  9.05, 3.5, 0.75, '#37474F', 'Feature',      fontsize=9, bold=True, radius=0.1)
rounded_box(ax, 4.6,  9.05, 7.2, 0.75, C_COMPRESS,'COMPRESSIVE',  fontsize=9, bold=True, radius=0.1)
rounded_box(ax, 12.0, 9.05, 7.0, 0.75, C_INFLAM,  'NON-COMPRESSIVE', fontsize=9, bold=True, radius=0.1)

rows = [
    ('Onset',     'Gradual / subacute',           'Sudden (vascular) or subacute (inflam.)'),
    ('Pain',      'Vertebral / radicular pain',    'Absent or midline; post-infectious hx'),
    ('Fever',     'Present (abscess)',             'May be present (post-viral)'),
    ('MRI',       'Epidural mass, cord compressed','Intramedullary T2 signal change'),
    ('CSF',       'Usually normal',                'Pleocytosis + ↑ protein (inflammatory)'),
    ('Key Clue',  'Malignancy / anticoagulation',  'Young + optic neuritis = MS/NMOSD'),
    ('Treatment', '🚨 Surgery / Antibiotics URGENT','Steroids / PLEX / Antivirals'),
]
row_colors = ['#ECEFF1', '#F5F5F5']
for i, (feat, comp, noncomp) in enumerate(rows):
    ry = 9.05 - (i+1)*0.82
    bg = row_colors[i % 2]
    rounded_box(ax, 1.0,  ry, 3.5, 0.72, bg,          feat,    fontsize=8.2, text_color='#212121', radius=0.08, bold=True)
    rounded_box(ax, 4.6,  ry, 7.2, 0.72, '#FFEBEE',   comp,    fontsize=8.0, text_color='#B71C1C', radius=0.08)
    rounded_box(ax, 12.0, ry, 7.0, 0.72, '#E0F2F1',   noncomp, fontsize=8.0, text_color='#004D40', radius=0.08)

# ══════════════════════════════════════════════════════
# MRI FINDINGS LEGEND  (y=2.0 .. 3.2)
# ══════════════════════════════════════════════════════
rounded_box(ax, 1, 2.8, 18, 0.6, '#455A64',
            'KEY MRI FINDINGS', fontsize=10, bold=True, radius=0.25)

mri_items = [
    ('Epidural mass / cord\ncompression', C_COMPRESS, 'Compressive'),
    ('Pencil sign +\nOwl\'s eyes (axial)', C_VASCULAR, 'Cord Ischemia'),
    ('Short T2 lesion\n(<2 vertebral seg)', '#1565C0', 'Multiple Sclerosis'),
    ('LETM >3 seg +\nAQP4-IgG +ve', C_INFLAM, 'NMOSD'),
    ('Cord swelling +\ngad. enhancement', '#F57F17', 'ATM / Inflammatory'),
]
for i, (label, color, title) in enumerate(mri_items):
    xi = 1.0 + i * 3.65
    rounded_box(ax, xi, 1.9, 3.4, 0.75, color, f'{title}\n{label}',
                fontsize=7.5, radius=0.2, lineheight=1.4)

# ══════════════════════════════════════════════════════
# FOOTER
# ══════════════════════════════════════════════════════
rounded_box(ax, 1, 0.7, 18, 0.9, C_FOOT,
            'Source: Harrison\'s Principles of Internal Medicine 22E  |  Localization in Clinical Neurology 8E\n'
            'For MBBS Exam Preparation  |  Orris Medical Education',
            fontsize=8.5, radius=0.3, lineheight=1.5)

plt.tight_layout(pad=0)
plt.savefig('/tmp/workspace/myelopathy-poster/acute_transverse_myelopathy_poster.png',
            dpi=180, bbox_inches='tight', facecolor=fig.get_facecolor())
plt.close()
print("Poster saved successfully.")
Running Command

cd /tmp/workspace/myelopathy-poster && python generate_poster.py 2>&1

Editing File

~/myelopathy-poster/generate_poster.py

Successfully replaced 1 instance(s) of the string in '/tmp/workspace/myelopathy-poster/generate_poster.py'
Editing File

~/myelopathy-poster/generate_poster.py

Successfully replaced 1 instance(s) of the string in '/tmp/workspace/myelopathy-poster/generate_poster.py'
Editing File

~/myelopathy-poster/generate_poster.py

Successfully replaced 1 instance(s) of the string in '/tmp/workspace/myelopathy-poster/generate_poster.py'
Editing File

~/myelopathy-poster/generate_poster.py

Successfully replaced 1 instance(s) of the string in '/tmp/workspace/myelopathy-poster/generate_poster.py'
Running Command

cd /tmp/workspace/myelopathy-poster && python generate_poster.py 2>&1

Running Command

ls -lh /tmp/workspace/myelopathy-poster/

Loading Image
Your diagnostic flowchart poster is ready! Download it here:

acute transverse myelopathy poster

Image · PNG


What's on the poster (top to bottom):
  1. Header - Title in navy blue
  2. Triad boxes - Motor / Sensory / Autonomic in color-coded boxes
  3. Central urgent step - MRI Spine with Gadolinium (red, prominent)
  4. Left branch (red) - Compressive: causes (TEHSD mnemonic), clinical clues, Emergency Decompression box
  5. Right branch (teal/purple) - Non-compressive split into Vascular (anterior spinal artery syndrome, MRI pencil/owl's eye signs) and Inflammatory/Infective (MS, NMOSD, ATM, viral)
  6. Investigations panel - Blood, CSF, antibody panel, imaging for non-compressive cases
  7. Comparison table - 7-row side-by-side: Onset / Pain / Fever / MRI / CSF / Key clue / Treatment
  8. MRI findings legend - 5 color-coded boxes for rapid MRI pattern recognition
  9. Footer - Source (Harrison's 22E) and exam prep label
Print it at A3 or A2 size for best readability.
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