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Spinal Arachoid Cyst

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This was a patient who have had previous surgery on the

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brain and was presenting with a thoracic myelopathy.

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We have the T1-weighted,

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T2-weighted and post-gad T1-weighted scans showing.

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In this situation, what we see is that there is indeed

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abnormal signal intensity within the spinal cord

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beginning at the cervical thoracic junction.

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As we look further inferiorly,

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we come into this bright signal intensity area on the

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sagittal STIR image, which is intradural

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but extramedullary, as we can see, with widening

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of the subarachnoid space.

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There is no evidence of contrast enhancement

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associated with the abnormality.

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Axial scans confirm the intradural

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extramedullary location of the cysts.

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We can see the fluid collection within the thecal sac

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causing displacement and deformity of the spinal cord,

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as well as abnormal signal intensity in the spinal cord.

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This is an example of an acquired arachnoid cyst

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secondary to adhesions that occurred postop from

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surgery that was performed intracranially.

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These cysts will not show contrast enhancement.

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In fact, let's go see the post gad T1 scans through the similar

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region. So you see absence of contrast enhancement.

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We're a little bit too low there.

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But on the scans,

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you don't see enhancing areas within the spinal cord.

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And this is a nice example if I magnify this one where

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you can see the non-enhancing CSF signal intensity

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lesion displacing the spinal cord within the thecal sac.

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So, intradural extramedullary cyst compressing the spinal

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cord in this kind of ball valve effect and leading

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to abnormal signal intensity in the spinal cord

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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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