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Dural Ectasia

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This is a patient who presented

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with myelopathic symptoms.

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On the T2-weighted and post-gad T1-weighted scans,

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we see the marked scalloping of the vertebral bodies

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greater than 50% of the vertebral body anterior

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posterior diameter. And this is evident at L1, L2,

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L3, and L4.

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What's pretty dramatic about this

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case is that even posteriorly,

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you do see some element of the dural ectasia.

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When we look on the coronal scan,

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we see the expansion of the CSF space to the

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right side more so than to the left side,

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and going through what appear

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to be the neural foramina.

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And that is verified on the parasagittal scans where you

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see the nerve roots expanding out through the CSF.

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Now, these type of dural ectasias could be a source of

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intracranial hypotension. That is low pressure within the

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spinal canal, secondary to these dural ectasias. durorectasias.

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Intracranial hypotension is manifested clinically

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by headaches that are postural.

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In other words, as soon as the patient sits up,

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they get severe headaches.

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These may also be secondary to CSF leakage,

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as far as the etiology for intracranial hypotension.

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Just want to point out that you note that there is no

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evidence of contrast enhancement on

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the T1 post-contrast scan.

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So there are no tumors or cystic

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neoplasms that are present,

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which you would require to do the post-gadolinium

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enhanced scan to rule out.

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So an example of extreme dural ectasia.

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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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