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Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
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Unlock access to our full Course Library and all self-paced Fellowships.
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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 was a patient who have had previous surgery on the
0:04
brain and was presenting with a thoracic myelopathy.
0:09
We have the T1-weighted,
0:10
T2-weighted and post-gad T1-weighted scans showing.
0:14
In this situation, what we see is that there is indeed
0:17
abnormal signal intensity within the spinal cord
0:20
beginning at the cervical thoracic junction.
0:23
As we look further inferiorly,
0:25
we come into this bright signal intensity area on the
0:28
sagittal STIR image, which is intradural
0:32
but extramedullary, as we can see, with widening
0:35
of the subarachnoid space.
0:38
There is no evidence of contrast enhancement
0:42
associated with the abnormality.
0:45
Axial scans confirm the intradural
0:49
extramedullary location of the cysts.
0:53
We can see the fluid collection within the thecal sac
0:57
causing displacement and deformity of the spinal cord,
1:01
as well as abnormal signal intensity in the spinal cord.
1:05
This is an example of an acquired arachnoid cyst
1:10
secondary to adhesions that occurred postop from
1:14
surgery that was performed intracranially.
1:17
These cysts will not show contrast enhancement.
1:20
In fact, let's go see the post gad T1 scans through the similar
1:24
region. So you see absence of contrast enhancement.
1:27
We're a little bit too low there.
1:30
But on the scans,
1:32
you don't see enhancing areas within the spinal cord.
1:36
And this is a nice example if I magnify this one where
1:41
you can see the non-enhancing CSF signal intensity
1:46
lesion displacing the spinal cord within the thecal sac.
1:51
So, intradural extramedullary cyst compressing the spinal
1:57
cord in this kind of ball valve effect and leading
2:00
to abnormal signal intensity in the spinal cord
2:03
and a myelopathy as an acquired arachnoid cyst.
Interactive Transcript
0:01
This was a patient who have had previous surgery on the
0:04
brain and was presenting with a thoracic myelopathy.
0:09
We have the T1-weighted,
0:10
T2-weighted and post-gad T1-weighted scans showing.
0:14
In this situation, what we see is that there is indeed
0:17
abnormal signal intensity within the spinal cord
0:20
beginning at the cervical thoracic junction.
0:23
As we look further inferiorly,
0:25
we come into this bright signal intensity area on the
0:28
sagittal STIR image, which is intradural
0:32
but extramedullary, as we can see, with widening
0:35
of the subarachnoid space.
0:38
There is no evidence of contrast enhancement
0:42
associated with the abnormality.
0:45
Axial scans confirm the intradural
0:49
extramedullary location of the cysts.
0:53
We can see the fluid collection within the thecal sac
0:57
causing displacement and deformity of the spinal cord,
1:01
as well as abnormal signal intensity in the spinal cord.
1:05
This is an example of an acquired arachnoid cyst
1:10
secondary to adhesions that occurred postop from
1:14
surgery that was performed intracranially.
1:17
These cysts will not show contrast enhancement.
1:20
In fact, let's go see the post gad T1 scans through the similar
1:24
region. So you see absence of contrast enhancement.
1:27
We're a little bit too low there.
1:30
But on the scans,
1:32
you don't see enhancing areas within the spinal cord.
1:36
And this is a nice example if I magnify this one where
1:41
you can see the non-enhancing CSF signal intensity
1:46
lesion displacing the spinal cord within the thecal sac.
1:51
So, intradural extramedullary cyst compressing the spinal
1:57
cord in this kind of ball valve effect and leading
2:00
to abnormal signal intensity in the spinal cord
2:03
and a myelopathy as an acquired arachnoid cyst.
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
Acquired/Developmental
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