Letter to the Editor
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Jul 28, 2025; 17(7): 110385
Published online Jul 28, 2025. doi: 10.4329/wjr.v17.i7.110385
Spinal cord ischemia: The “snake bite sign”
Nikolaos-Achilleas Arkoudis, Anastasia Karachaliou, George Triantafyllou, Andreas Papadopoulos, Christos Koutserimpas, Georgios Velonakis
Nikolaos-Achilleas Arkoudis, Anastasia Karachaliou, Andreas Papadopoulos, Georgios Velonakis, Department of Radiology 2nd, General University Hospital “Attikon”, National and Kapodistrian University of Athens, Chaidari 12462, Attikí, Greece
Nikolaos-Achilleas Arkoudis, Georgios Velonakis, Research Unit of Radiology and Medical Imaging, National and Kapodistrian University of Athens, Athens 11528, Attikí, Greece
George Triantafyllou, Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Goudi 11527, Greece
Christos Koutserimpas, School of Rehabilitation Health Sciences, University of Patras, Patra 26504, Dytikí Elláda, Greece
Author contributions: Arkoudis NA, Karachaliou A, Triantafyllou G, and Papadopoulos A wrote the main manuscript text and prepared the figure; Arkoudis NA, Koutserimpas C, and Velonakis G assisted with conceptualization and provided supervision; and all authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nikolaos-Achilleas Arkoudis, MD, PhD, Academic Fellow, Consultant, Lecturer, Research Fellow, Researcher, Department of Radiology 2nd, General University Hospital “Attikon”, National and Kapodistrian University of Athens, 1 Rimini Street, Chaidari 12462, Attikí, Greece. narkoudis@med.uoa.gr
Received: June 5, 2025
Revised: June 19, 2025
Accepted: July 14, 2025
Published online: July 28, 2025
Processing time: 50 Days and 10.6 Hours
Core Tip

Core Tip: We propose renaming the “owl’s eyes” or “snake eyes” sign seen in spinal cord pathologies such as ischemia to the “snake bite sign”. This term retains the visual metaphor while adding clinical relevance, as it mirrors both the appearance (two fang-like dots) and neurological consequences of an elsewhere occurring venomous snake bite. It enhances educational impact and diagnostic clarity in spinal cord pathology, especially anterior spinal artery infarction when symmetrical anterior-horn hyperintensities appear.