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Prominent Transdural Herniation of the Spinal Cord

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I wanted to demonstrate this most

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dramatic case that I have seen,

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that is in the differential diagnosis

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of an arachnoid cyst.

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We have the post myelogram CT on either side of

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the T2-weighted scan of the spinal cord.

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On this T2-weighted scan,

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you see that the cord is deviated dramatically anteriorly.

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In fact, the cord is leading to scalloping

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of the mid thoracic vertebrae,

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and there is dilatation of the subarachnoid

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space posteriorly.

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This is another example of probably the most

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dramatic case of transdural herniation of

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the spinal cord that I've seen.

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Here on the sagittal reconstructions

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of the post myelogram CT,

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we have the spinal cord coming up

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here from the lumbar region.

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And then you have the spinal cord being

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deviated and causing scalloping of vertebrae.

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And you have the subarachnoid space

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dilatation, so this cord has herniated through

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the dura, transdural spinal cord herniation

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and subarachnoid space

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dilatation. In this example, was secondary to trauma.

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This is a very unusual complication and

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oftentimes, the trauma is subclinical.

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In other words,

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the patient has had a remote history

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of a motor vehicle collision.

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And we find the patient with a thoracic myelopathy

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months to years later demonstrating this phenomenon.

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So again,

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transdural herniation of the spinal cord.

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The most dramatic example that I've seen.

Report

Description

Faculty

David M Yousem, MD, MBA

Professor of Radiology, Vice Chairman and Associate Dean

Johns Hopkins University

Tags

Trauma

Spine

Neuroradiology

Musculoskeletal (MSK)

MRI

Acquired/Developmental

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