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Department of Radiology University of California San Diego John R. Hesselink, M.D. Imaging the Spinal Cord & Intradural Disease

Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

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Page 1: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Department of Radiology

University of California

San Diego

John R. Hesselink, M.D.

Imaging the Spinal Cord

& Intradural Disease

Page 2: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Spinal Cord Diseases

Tumors

Syringohydromyelia

Trauma

Ischemia / Infarction

Vascular malformations

Inflammatory / Degenerative

Page 3: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Spinal Cord Tumors

Ependymoma

Astrocytoma

Oligodendroglioma

Hemangioblastoma

Teratoma, epidermoid, dermoid, lipoma

Metastases

Page 4: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Spinal Cord Tumors

Expansion of the cord

Heterogeneous T2 signal

Cysts & necrosis

Variable enhancement

Imaging Features

Page 5: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

History: 58 y/o man with neck pain

& paresthesias in fingertips

642

Page 6: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Dx: Ependymoma

{Page 2}

Page 7: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

History: 43 y/o male with bilateral arm

paresthesias & weakness

673

Page 8: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Dx: Pilocytic astrocytoma

{Page 2}

Page 9: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

History: 19 y/o male with progressive

leg weakness for 2 years

480

Page 10: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Dx: Pylocytic astrocytoma

{Page 2}

Page 11: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

CD 33-35

Hemangioblastoma

Page 12: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Dx: Hemangioblastoma

History: 55 y/o woman with pain

& tingling in the extremities

754

Page 13: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Dorsal Dermal Sinus

with Dermoid Tumor

LB 19-20

Page 14: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

History: 69 y/o man with progressive

weakness in his arms & legs

458

Page 15: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Dx: Lung CA

{Page 2}

Page 16: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

History: 40 y.o. man with pain & paresthesias

in both arms & shoulders

136

Page 17: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Dx: NF 2 with intramedullary

neurofibroma

{Page 2}

Page 18: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Chiari I with syrinx

CB-7

Page 19: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Dx: Chiari I malformation

with syringohydromyelia

339

History: 22 y/o male with

brain stem dysfunction

Page 20: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

History: 45 y.o. male with a

progressive myelopathy

101

C1

C6

C5

Page 21: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

{Page 2}

T5

T9

T6

Page 22: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

History: 31 y/o woman with severe back pain

556

Page 23: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Dx: Pilocytic astrocytoma

{Page 2}

Page 24: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

History: 56 y/o man with C6 quadriplegia

following an MVA 5 years ago

223

Page 25: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Dx: Old cord contusion with

a post-traumatic syrinx

and cord atrophy

{Page 2}

A

B

C

A

B

C

Page 26: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Spinal Cord Cysts

Fluid isointense to CSF

Smooth, well-defined internal margins

Thinned adjacent parenchyma

Cord atrophy

No contrast enhancement

Presence of Chiari malformation

Evidence for Benign Syrinx

Page 27: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Spinal Cord Masses

Cord contusion

Multiple sclerosis

Vascular malformation

Parasitic disease

Abscess

Sarcoidosis

Non-Tumorous Lesions

Page 28: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

History: 18 y/o male became tetraplegic

while surfing in Puerto Vallarta

278

Page 29: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

{Page 2}

C3 C4

Page 30: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Dx: Fractures C3 & C4;

Posterior ligamentous injury;

Cord contusion

Tetraplegia {Page 3}

Page 31: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

History: 44 y.o. man

fell off a roof onto his head

Page 32: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

History: 35 woman with MS

784 - 24604803

T2 FSE PD

T1 FSE STIR

Page 33: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Dx: MS - MERGE

{Page 2}

T2 FSE MERGE

Page 34: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

History: 27 y/o woman with muscular

dystrophy & new left sided numbness

577

Dx: Transverse myelitis (ADEM)

- Bronchitis 3 weeks ago

Page 35: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

History: 23 y/o female with leg

weakness & sensory changes

593

Page 36: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

{Page 2}

Page 37: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Dx: Neuromyelitis optica –

Devic’s disease

{Page 3}

2 years later

Page 38: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Dx: Acute cord infarction

History: 95 y/o woman with acute

bilateral upper extremity weakness

746 - 05121249

Page 39: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Intramedullary AV Malformation

LH 9-12

Page 40: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

History: 36 y/o man with a chronic C6-8 radiculopathy

620

Page 41: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Dx: Spinal dural AVM

{Page 2}

Page 42: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Tuberculoma of the

Spinal Cord

TC 13-15

Page 43: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

T1W T1W+GD

Schistosomiasis

Courtesy of Bassem Georgy, San Diego, California

Page 44: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Intradural

Extramedullary Tumors

Schwannoma / Neurofibroma

Meningioma

Metastatic disease

Page 45: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Primary Intraspinal Tumors

Schwannoma

Meningioma

Glioma Sarcoma

Vascular

Chordoma

Other

2% 3%

5%

10% 20%

35% 25%

Page 46: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Schwannoma

CD 29-31

Page 47: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

History: 42 y/o woman with anterior chest pain

& lower extremity weakness

608

Page 48: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Dx: Schwannoma

{Page 2}

Page 49: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Nerve Sheath Tumors

Originate from Schwann cells

Associated with Neurofibromatosis

Foraminal enlargement

Intradural/extradural components

Long T1, long T2

Bright enhancement

Page 50: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

History: 23 y/o male with

cauda equina syndrome

501

Page 51: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Dx: Schwannoma

{Page 2}

Page 52: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Neurofibromatosis Type 1

CD-15

Page 53: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Dx: NF 1

{Page 4}

Page 54: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Dx: Meningioma

History: 54 male with leg weakness

& a T3 sensory level

743 – h1079

Page 55: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Spinal Meningioma

Arise from meninges - intradural

Middle-aged females

80% in thoracic region

MR signal similar to cord

Intense enhancement

Page 56: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

218

History: 43 y/o male with back

& bilateral leg pain

Page 57: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Dx: Intradural Paraganglioma

{Page 2}

Page 58: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

History: 43 y/o man with

back pain for several months

553 CV

Page 59: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Dx: Hemangioblastoma

{Page 2}

Page 60: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Dx: Arachnoid cyst

History: 35 y/o female with pain

& weakness in both legs

763 -

DWI

Page 61: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

History: 22 y/o female with flank pain

& progressive leg weakness

526

Page 62: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Dx: Lymphocytic Leukemia

{Page 2}

Page 63: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Intradural Metastases

CNS neoplasms - "drop metastases"

Medulloblastoma, ependymoma

pineal tumors, glioblastoma

Non-CNS neoplasms

Breast, lung, melanoma,

lymphoma, leukemia

Imaging: Gadolinium with

fat suppression

Page 64: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Intradural Metastases

Nodular masses

Coating of cord & nerve roots

Gelatinous & non-enhancing

Intramedullary

MR Appearance

Page 65: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

History: 59 y/o man

with increasing leg weakness

494

Page 66: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

{Page 2}

Page 67: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Dx: Melanoma with drop mets

{Page 3}

Page 68: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Cerebellar Glioblastoma

with Diffuse Pial Seeding

TD 53-54

Page 69: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

{Page 2}

TD 53-54

Page 70: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Medulloblastoma

with Leptomeningeal Seeding

td-10-12

Page 71: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

{Page 2}

T1W T2W T1-Gd

Page 72: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Infection and Inflammation

Meningitis

Sarcoidosis

CMV polyradiculopathy

Guillain Barre syndrome

Arachnoiditis

Intradural

Page 73: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Chronic Cocci Meningitis

Page 74: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

History: 37 man with progressive lower

body weakness over 4 days

782 - 26016550

Page 75: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Dx: Gullain Barre

Page 2

Page 76: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

History: 54 y/o male s/p multiple

surgeries with chronic back & leg pain

273

Page 77: Imaging the Spinal Cord & Intradural Diseasespinwarp.ucsd.edu/NeuroWeb/PPT/sp-intradural-45.pdf · Imaging the Spinal Cord & Intradural Disease . Spinal Cord Diseases ... Meningioma

Dx: Chronic arachnoiditis

with "empty sac sign"

{Page 2}