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For Private Practices
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Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
42 topics, 2 hr. 16 min.
Introduction to Intradural Extramedullary Lesions
4 m.Standard MRI Pulse Sequences for Evaluating Spinal Lesions
3 m.Cystic Lumbar Schwanoma
4 m.Lumbar Spine Solid Schwanoma vs. Meningioma
3 m.Cervical Spine Plexiform Neurofibroma in a Patient with NF1
6 m.Intradural Extramedullary Lesion Differential Diagosis
3 m.Nerve Sheath Tumors of the Spine
5 m.Neurofibromatosis Type 2
4 m.Neurofibromatosis Type 1
4 m.Spinal Meningiomas
5 m.Thoracic Spine Meningioma
4 m.Calcified Meningioma
3 m.Cervical Spine Meningioma
4 m.Cervical Spine Meningioma, Atypical Location
4 m.Spinal Hemangioblastomas
3 m.Multiple Hemangioblastomas, Von Hippel Lindau
4 m.Myxopapillary Ependymoma
4 m.Spinal Paraganglioma
2 m.Differential Diagosis of Intradural Metastasis
10 m.Subarachnoid Seeding from Medulloblastoma
4 m.Subarachoid Seeding in a Breast Cancer Patient
3 m.Spinal Lymphoma
2 m.Congenital and Developmental IDEM Cysts
8 m.Neurenteric Cysts
4 m.Transdural Herniation of the Spinal Cord
3 m.Spinal Arachoid Cyst
3 m.Prominent Transdural Herniation of the Spinal Cord
2 m.Fat Containing Spine Lesions
4 m.Lumbar Spine Lipoma
2 m.Pediatric Lumbar Lipoma and a Congenital Malformation
3 m.Lipoma vs. Fatty Infiltration of the Filum
3 m.Congenital Dural Ectasia
3 m.Dural Ectasia
2 m.Dural Arteriovenous Fistula Type 1
4 m.Dural AVF vs. Normal Variation
5 m.Review of Dural AVF Types II, III, and IV
3 m.IDEM Infectious and Inflammatory Abormalities
6 m.Guillian Barre Syndrome
3 m.Chronic Inflammatory Demyelinating Polyradiculoneuropathy
3 m.CIDP Causing Cauda Equina Syndrome
3 m.CIDP Causing Brachial Plexopathy
3 m.Indradural Extramedullary Processes - Conclusion
2 m.0:01
Although we described chronic inflammatory demyelinating
0:04
polyradiculoneuropathy and the hypertrophic motor
0:08
sensory neuropathy syndromes when we were talking
0:12
about intradural extramedullary lesions,
0:15
the truth is that these may be purely extradural
0:18
diseases of the nerve roots.
0:21
CIDP is an acquired disorder usually thought to be an
0:24
autoimmune disorder in which the patients present
0:27
with proximal weakness and paresthesias,
0:29
they may affect the cranial nerves or the peripheral
0:32
nerves, and it is usually a bilateral and symmetric
0:36
process. When it's unilateral or asymmetric, it may be
0:40
called MMN, which is Multifocal Motor Neuropathy.
0:45
Here we have examples of a patient who has enlargement
0:48
of the nerve roots which is predominantly in
0:50
the extradural compartment. As you can see,
0:53
this is going through the anterior scaling,
0:55
middle scaling junction involving the brachial plexus.
1:00
And this is on T2-weighted scan,
1:02
T1-weighted scan, and you see that there are enlarged
1:05
neuroforamina, as well as the involvement of the
1:08
nerves as they go into the brachial plexus.
1:11
So this is called CIDP and it is, again, an autoimmune
1:16
disorder which is often treated with immunosuppressive
1:20
medications and definitively with plasmapheresis.
1:24
In the differential diagnosis with CIDP are the
1:28
hereditary motor and sensory neuropathy
1:30
syndrome, such as your Charcot-Marie-Tooth disease and Dejerine–Sottas disease,
1:36
which may be purely extradural.
1:39
Also in the differential diagnosis, one may find some of the mucopolysaccharidoses
1:44
which also may be associated with enlarged
1:46
nerve roots, as well as dural thickening,
1:49
most commonly at the foramen magnum
1:52
and C1-C2 junction.
1:54
So these are causes of enlarged extradural nerve roots.
Interactive Transcript
0:01
Although we described chronic inflammatory demyelinating
0:04
polyradiculoneuropathy and the hypertrophic motor
0:08
sensory neuropathy syndromes when we were talking
0:12
about intradural extramedullary lesions,
0:15
the truth is that these may be purely extradural
0:18
diseases of the nerve roots.
0:21
CIDP is an acquired disorder usually thought to be an
0:24
autoimmune disorder in which the patients present
0:27
with proximal weakness and paresthesias,
0:29
they may affect the cranial nerves or the peripheral
0:32
nerves, and it is usually a bilateral and symmetric
0:36
process. When it's unilateral or asymmetric, it may be
0:40
called MMN, which is Multifocal Motor Neuropathy.
0:45
Here we have examples of a patient who has enlargement
0:48
of the nerve roots which is predominantly in
0:50
the extradural compartment. As you can see,
0:53
this is going through the anterior scaling,
0:55
middle scaling junction involving the brachial plexus.
1:00
And this is on T2-weighted scan,
1:02
T1-weighted scan, and you see that there are enlarged
1:05
neuroforamina, as well as the involvement of the
1:08
nerves as they go into the brachial plexus.
1:11
So this is called CIDP and it is, again, an autoimmune
1:16
disorder which is often treated with immunosuppressive
1:20
medications and definitively with plasmapheresis.
1:24
In the differential diagnosis with CIDP are the
1:28
hereditary motor and sensory neuropathy
1:30
syndrome, such as your Charcot-Marie-Tooth disease and Dejerine–Sottas disease,
1:36
which may be purely extradural.
1:39
Also in the differential diagnosis, one may find some of the mucopolysaccharidoses
1:44
which also may be associated with enlarged
1:46
nerve roots, as well as dural thickening,
1:49
most commonly at the foramen magnum
1:52
and C1-C2 junction.
1:54
So these are causes of enlarged extradural nerve roots.
Report
Description
Faculty
David M Yousem, MD, MBA
Professor of Radiology, Vice Chairman and Associate Dean
Johns Hopkins University
Tags
Spine
Non-infectious Inflammatory
Neuroradiology
Musculoskeletal (MSK)
MRI
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