Dilation of spinal epidural veins caused by spontaneous intracranial hypotension: case report.
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A 30-year-old woman presented with headache which occurred when standing up from a recumbent position. Magnetic resonance (MR) imaging of the brain revealed slightly diffuse enhancement of the dura mater and two ventral extradural spinal flow voids in the supine position. Radionuclide cisternography identified cerebrospinal fluid leakage localized below the cervical level. Vertebral angiography demonstrated two dilated ventral extradural veins. The patient was treated by conservative therapy and improved with rest. The unusual clinical presentation with dilation of two epidural veins indicates the diagnostic value of MR imaging in cases of spontaneous intracranial hypotension. (+info)
Spinal extradural meningeal cysts are typically formed by a thin fibrotic membranous capsule, macroscopically similar that of an arachnoid membrane, filled by cerebro spinal fluid and related to a nerve root or to the posterior midline. Ventral location is extremely rare and when it occurs they usually cause spinal cord herniation through the ventral dural gap. A 61 year-old man who began with a two years long history of insidious tetraparesis, spasticity and hyperreflexia in lower extremities, and flaccid atrophy of upper limbs, without sensory manifestations, is presented. Investigation through magnetic resonance imaging demonstrated an extensive spinal ventral extradural cystic collection from C6 to T11. The lesion was approached through a laminectomy and a cyst-peritoneal shunt was introduced. The cyst reduced in size significantly and the patient is asymptomatic over a 48 months follow-up. This is the first reported case of a spontaneous ventral extradural spinal meningeal cyst causing cord compression. Cyst-peritoneal shunt was effective in the treatment of the case and it should be considered in cases in which complete resection of the cyst is made more difficult or risky by the need of more aggressive surgical maneuvers. (+info)
Epidural blood patch at C2: diagnosis and treatment of spontaneous intracranial hypotension.
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Spontaneous intracranial hypotension in a 37-year-old man with intractable headaches was diagnosed on MR imaging. A generous CSF leak was identified at C2 on CT myelography. Successful treatment was performed with CT-guided blood patch at the leakage site after the patient had failed 2 lumbar blood patches. Imaging-guided precise placement of the blood patch is safe and recommended when a lumbar blood patch away from the leakage site could be ineffective. (+info)
CT myelography of the thoraco-lumbar spine in 8 dogs with degenerative myelopathy.
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CT myelography of the T11-L2 region was performed in 8 large-breed dogs with a clinical diagnosis of degenerative myelopathy (DM) and 3 large-breed dogs that were clinically normal. CT myelographic characteristics were recorded for each dog, at each disc level. Area measurements of the spinal cord, dural sac, vertebral canal, and vertebral body were recorded at 4 slice locations for each disc level. Mean area ratios were calculated and graphically compared, by slice location and group. In all dogs, CT myelography identified morphologic abnormalities that were not suspected from conventional myelograms. Characteristics observed with higher frequency in DM versus normal dogs were: spinal stenosis, disc protrusion, focal attenuation of the subarachnoid space, spinal cord deformity, small spinal cord, and paraspinal muscle atrophy. Mean spinal cord:dural sac, spinal cord:vertebral canal, dural sac: vertebral canal, and vertebral canal:vertebral body ratios were smaller in DM versus normal dogs at more than one disc level. Some CT myelographic characteristics in DM dogs were similar to those previously reported in humans, dogs and horses with stenotic myelopathy. (+info)
Acute paraplegia resulting from haemorrhage into a spinal neurofibroma.
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Acute paraplegia due to the intratumour haemorrhage of spinal neurofibroma is a rare condition. We describe 2 patients with this unusual presentation. Surgical treatment was successful in both patients. These 2 cases are reported, and the literature is reviewed. (+info)
Iopamidol myelography-induced seizures.
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Iopamidol, a water-soluble contrast agent, has been rarely associated with seizures. We describe a case of generalized tonic-clonic seizure after cervical myelography with iopamidol in a previously healthy young man. In patients presenting with seizures, a history of recent myelography should be considered as an etiology. Iopamidol myelography may be associated with a risk of seizures. Clinicians need to be aware of this complication and inform their patients about such risk. (+info)
Comparison of the predictive value of myelography, computed tomography and MRI on the treadmill test in lumbar spinal stenosis.
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To date, there have been no prospective, objective studies comparing the accuracy of the MRI, myelo-CT and myelography. The purpose of this study is to compare the diagnostic and predictive values of MRIs, myelo-CTs, and myelographies. Myelographies with dynamic motion views, myelo-CTs, MRIs and exercise treadmill tests were performed in 35 cases. The narrowest AP diameter of the dural sac was measured by myelography. At the pathologic level, dural cross-sectional area (D-CSA) was calculated in the MRI and Myelo-CT. The time to the first symptoms (TAF) and the total ambulation time (TAT) were measured during the exercise treadmill test and used as the standard in the comparison of correlation between radiographic parameters and walking capacity. The mean D-CSA by CT was 58.3 mm(2) and 47.6 mm(2) by MRI. All radiographic parameters such as AP diameters and D-CSA have no correlation to TAF or TAT (p > 0.05). Our data showed no statistically significant differences in the correlation of the patients' walking capacity to the severity of stenosis as assessed by myelography, myelo-CT and MRI. (+info)
Cervical myelopathy due to nuclear herniations in young adults: clinical and radiological profile, results of microdiscectomy without interbody fusion.
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A study was made of the clinical and radiological characteristics and the results of microsurgical discectomy without interbody fusion, of 26 young adults, who presented with cervical myelopathy due to nuclear herniations. Neck trauma was not a significant aetiological factor. The disease produced moderate to very severe functional disability in most patients (73%), in a relatively short period (mean symptom duration 6.3 months). Radiological assessment revealed the presence of canal stenosis, significant disc protrusions with paucity of spondylotic changes in most patients. At operation, soft disc lesions were found in 85% and sequestrated discs in 31%. Microsurgical discectomy without fusion produced gratifying recovery of functional disability without significant deleterious effects on the cervical spine. (+info)