Pearls & oy-sters: the use of CT venography in Hirayama disease.

• Hirayama disease is characterized by progressive, yet self-limited, neurogenic wasting and weakness of the distal upper extremities. • Its pathogenesis is unclear. We present the case of a typical young man with Hirayama disease in which CT venography (CTV) of the neck in attempted neck flexion showed engorgement of the epidural venous plexus, anterior displacement of the dura, and posterior compression of the cord even when MRI did not.