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Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
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For Private Practices
Upskill in high growth, advanced imaging areas.
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
This is a patient who presented
0:03
with myelopathic symptoms.
0:05
On the T2-weighted and post-gad T1-weighted scans,
0:09
we see the marked scalloping of the vertebral bodies
0:14
greater than 50% of the vertebral body anterior
0:17
posterior diameter. And this is evident at L1, L2,
0:21
L3, and L4.
0:22
What's pretty dramatic about this
0:24
case is that even posteriorly,
0:26
you do see some element of the dural ectasia.
0:30
When we look on the coronal scan,
0:32
we see the expansion of the CSF space to the
0:36
right side more so than to the left side,
0:38
and going through what appear
0:39
to be the neural foramina.
0:41
And that is verified on the parasagittal scans where you
0:46
see the nerve roots expanding out through the CSF.
0:50
Now, these type of dural ectasias could be a source of
0:55
intracranial hypotension. That is low pressure within the
1:00
spinal canal, secondary to these dural ectasias. durorectasias.
1:05
Intracranial hypotension is manifested clinically
1:07
by headaches that are postural.
1:10
In other words, as soon as the patient sits up,
1:13
they get severe headaches.
1:15
These may also be secondary to CSF leakage,
1:19
as far as the etiology for intracranial hypotension.
1:23
Just want to point out that you note that there is no
1:25
evidence of contrast enhancement on
1:27
the T1 post-contrast scan.
1:29
So there are no tumors or cystic
1:31
neoplasms that are present,
1:33
which you would require to do the post-gadolinium
1:37
enhanced scan to rule out.
1:38
So an example of extreme dural ectasia.
1:42
In this case, it was isolated without a known syndrome.
Interactive Transcript
0:01
This is a patient who presented
0:03
with myelopathic symptoms.
0:05
On the T2-weighted and post-gad T1-weighted scans,
0:09
we see the marked scalloping of the vertebral bodies
0:14
greater than 50% of the vertebral body anterior
0:17
posterior diameter. And this is evident at L1, L2,
0:21
L3, and L4.
0:22
What's pretty dramatic about this
0:24
case is that even posteriorly,
0:26
you do see some element of the dural ectasia.
0:30
When we look on the coronal scan,
0:32
we see the expansion of the CSF space to the
0:36
right side more so than to the left side,
0:38
and going through what appear
0:39
to be the neural foramina.
0:41
And that is verified on the parasagittal scans where you
0:46
see the nerve roots expanding out through the CSF.
0:50
Now, these type of dural ectasias could be a source of
0:55
intracranial hypotension. That is low pressure within the
1:00
spinal canal, secondary to these dural ectasias. durorectasias.
1:05
Intracranial hypotension is manifested clinically
1:07
by headaches that are postural.
1:10
In other words, as soon as the patient sits up,
1:13
they get severe headaches.
1:15
These may also be secondary to CSF leakage,
1:19
as far as the etiology for intracranial hypotension.
1:23
Just want to point out that you note that there is no
1:25
evidence of contrast enhancement on
1:27
the T1 post-contrast scan.
1:29
So there are no tumors or cystic
1:31
neoplasms that are present,
1:33
which you would require to do the post-gadolinium
1:37
enhanced scan to rule out.
1:38
So an example of extreme dural ectasia.
1:42
In this case, it was isolated without a known syndrome.
Report
Description
Faculty
David M Yousem, MD, MBA
Professor of Radiology, Vice Chairman and Associate Dean
Johns Hopkins University
Tags
Spine
Neuroradiology
Musculoskeletal (MSK)
MRI
Congenital
Acquired/Developmental
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