What mechanism predominantly causes transverse myelitis?

Transverse myelitis is primarily caused by inflammation of the spinal cord, which is often triggered by infections. When a viral infection occurs, it can lead to an autoimmune response where the body's immune system mistakenly attacks the myelin, the protective sheath around nerve fibers in the spinal cord. This inflammation can disrupt the transmission of nerve signals and lead to various neurological symptoms such as weakness, sensory loss, and bladder dysfunction.

Infections, particularly viral ones like those caused by herpes viruses, can initiate this pathological process, making it a predominant mechanism behind transverse myelitis. The other options, while associated with various medical conditions, do not directly contribute to the development of transverse myelitis as primarily as an infection would. For instance, injuries affecting the heart or deficiencies in oxygen transport primarily relate to cardiovascular issues, while brain damage from viruses pertains to conditions affecting the brain rather than the spinal cord specifically.