Interactive Transcript
0:01
This was a 21-year-old who had an antecedent infection
0:05
approximately six weeks prior to presenting
0:07
with a brachial plexopathy.
0:11
The MRI of the brain was performed as well as the
0:14
cervical spine. The brain was unremarkable.
0:17
When we look at the cervical spine
0:19
on T2-weighted imaging,
0:20
we see enlargement of the nerve roots coming out of the
0:24
neuroforamina and extending into the brachial plexus.
0:28
Let's do a quick reminder about the
0:30
anatomy of the brachial plexus.
0:32
The brachial plexus is derived from the
0:35
C5 through T1 nerve roots.
0:37
And where we look for the brachial plexus, is behind
0:41
the anterior scaling muscle, so posterior to it,
0:45
but in front of the middle scaling,
0:47
posterior scaling muscle complex.
0:50
So it runs in that area between the two muscle groups.
0:54
And you can see that as bright signal intensity here on
0:58
the T2-weigghted scan coming from the neuroforamina.
1:02
Now, in this case,
1:03
the neuroforamina also appears to be enlarged bilaterally.
1:07
Again, brachial plexus coming through here,
1:10
and then it's going to run in close approximation to
1:12
the subclavian artery. Now, as we look at this,
1:16
we would say that this is a process which is extradural,
1:20
that is, outside the thecal sac.
1:22
However, on the post contrast scans,
1:24
we see that in point of fact,
1:26
these nerve roots are showing abnormal contrast
1:29
enhancement with the anterior and posterior
1:32
rootlets coming out of the spinal cord.
1:35
In the neuroforamina,
1:37
the nerve roots are also showing contrast enhancement
1:40
as they extend from there into the brachial plexus.
1:44
So this is indeed an intradural extra medullary, as well
1:49
as an extradural process associated with enlargement of
1:52
the nerve roots. In this case, an example of CIDP.
1:58
CIDP may or may not show contrast enhancement of the nerve roots,
2:03
but it does show enlargement,
2:05
as you can see in the neuroforamina.
2:08
If we were to look on a parasagittal
2:10
image in the cervical spine,
2:12
you would be able to see this as well manifesting as
2:16
enlarged neuroforamina with nerve roots coming out
2:19
and the enhancement intradural extramedullary.
© 2024 Medality. All Rights Reserved.