The following tests are needed to confirm the diagnosis of spinal cord cavernous disease X-ray examination may reveal malformation of the occipital foramen magnum, Charcot’s joints, etc. Myelography may show the lesion of the spinal cord with spindle enlargement and canal stenosis, but it is difficult to characterize. Myelography can show the spinal cord with spindle-shaped enlargement and narrowing of the spinal canal, but it is difficult to characterize it. MRI is the best method to diagnose spinal cord cavernous disease because it can show the abnormal image similar to the signal of the cerebrospinal fluid from the multiaxial level, and it can clearly show the scope, location, morphology, size of the cavernous cavity, and the associated other deformities. In all cases, MRI of the brain and spinal cord should be performed to examine the full extent of the cavern, to evaluate the structure of the posterior fossa, and to determine the presence or absence of hydrocephalus. If no Chiari malformation is found, an MRI contrast-enhanced scan should also be performed to look for possible abnormal enhancement of associated spinal cord tumors. To confirm the diagnosis of spinal cord cavernous disease, the following diseases should be excluded: 1. Tumors Brainstem tumors, extramedullary and intramedullary spinal cord tumors can cause limited myasthenia gravis as well as segmental sensory deficits. In cases of tumors, astrocytomas or ventricular meningiomas in the gray matter of the spinal cord secrete a proteinaceous fluid, which accumulates above and below the tumors and widens the spinal cord in diameter, resulting in a posterior spinal column protruding sideways with neurological symptoms, which can be similar to those of spinal cord cavernous disease. The tumor may resemble spinal cord cavernous disease, and it is sometimes difficult to distinguish the tumor from other tumors, especially those located in the lower cervical cord. However, the course of tumor cases is more rapid, preferred in children and adolescents, radicular pain is common, and nutritional disorders are rare. In advanced stage, there may be increased cranial pressure, and early cerebrospinal fluid with increased protein can be distinguished from this disease. MRI can identify the difficult cases. 2, cervical spine osteoarthropathy cervical spine osteoarthropathy, although there may be upper limb myasthenia and segmental sensory impairment, but there is no superficial sensory detachment, radicular pain is common, myasthenia is often mild, usually no nutritional disorders, the lesion level of obvious segmental sensory impairment is rare. Cervical spine radiography, myelography and cervical spine CT or MRI can help to confirm the diagnosis. Cervical ribs can cause limited atrophy of the small muscles of the hands and sensory deficits, with or without evidence of subclavian artery compression, and can be diagnostically confusing because of the frequent presence of cervical ribs in spinal cord cavernous disease. However, sensory deficits due to cervical ribs are usually limited to the ulnar aspect of the hand and forearm, with tactile deficits being more severe than nociceptive deficits. Upper arm tendon reflexes are unaffected, and the absence of cone-bundle signs allows for differentiation. Cervical spine radiographs are also helpful in establishing the diagnosis. Syphilis can be suspected of spinal cord cavernous disease in two ways: in the rare case of proliferative scleroderma, upper extremity sensory deficits, atrophy, and weakness, and cone-bundle signs in the lower extremities may be present, but myelography may show subarachnoid obstruction and the disease progresses more rapidly than in spinal cord cavernous disease. Syphilitic tumors of the spinal cord may show signs of intramedullary neoplasia, although the disease course is more rapidly progressive and seropositive for syphilis. Diagnosis is based on the slow progression of the disease, unilateral or bilateral segmental dissociative sensory deficits, unilateral muscle atrophy of the upper limbs or hands, neurotrophic deficits, and other congenital deficits in conjunction with the findings on MRI.