Training Collections
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
Training Collections
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
Lesson
Intradural Intramedullary Spinal Lesions Pre-Course Activities
1 topic, 4 min.
Lesson
Introduction to Spinal Imaging - Intradural Intramedullary Lesions
6 topics, 21 min.
Lesson
Neoplasms
13 topics, 42 min.
Neoplasms of the Intradural Intramedullary Space
1 m.Ependymoma Associated with NF2
4 m.Ependymoma
2 m.Myxopapillary Ependymoma
2 m.Cervical Spinal Cord Astrocytoma
4 m.Cervical Spinal Cord Glioblastoma
4 m.Hemangioblastoma of the Spinal Cord
4 m.Hemangioblastoma at the Conus Medullaris
4 m.Neurologic Manifestations of Von Hippel Lindau Disease
4 m.Additional Spinal Canal Manifestations of VHL
3 m.Cervical Spinal Cord Ganglioglioma
3 m.Rare Case of a Spinal Cord Lipoma
3 m.Summary of Intradural Intramedullary Neoplasms
12 m.Lesson
Demyelinating
4 topics, 17 min.
Lesson
Infection/Inflammation
7 topics, 33 min.
Acute Disseminated Encephalomyelitis of the Spinal Cord
4 m.Summary of Acute Disseminated Encephalomyelitis
2 m.Chiari 1 with Syringohydromyelia
5 m.Summary of congenital lesions of the spinal cord
11 m.Spinal Cord Infectious and Inflammatory Disorders
6 m.Cysticercosis of the Spinal Cord
4 m.Sarcoidosis of the Spinal Cord
5 m.Lesson
Trauma and Vascular Disorders
9 topics, 39 min.
Hemorrhage within the Spinal Cord
4 m.Hematomyelia and Spinal Cord Cavernomas
7 m.Cavernoma of the Spinal Cord
3 m.Dural Arteriovenous Fistula
5 m.Type II Dural AVF and its Potential Consequences
5 m.Intramedullary AVM in the setting of Type II Dural AVF
2 m.Assessing Vascular Malformations on MRA
5 m.Common Causes and Imaging of Spinal Cord Ischemia/Infarction
8 m.Spinal Cord Infarct
5 m.Lesson
Idiopathic/Acquired
4 topics, 16 min.
0:00
When considering intradural intramedullary
0:03
lesions in children,
0:04
we should consider the possibility of ADEM.
0:07
Remember that this was originally described as a
0:11
monophasic disease, but we now know that it,
0:13
too, may be polyphasic.
0:15
It occurs classically two to four weeks after
0:17
viral illnesses, most commonly,
0:20
immunizations, much less commonly.
0:23
It is a delayed type hypersensitivity type IV
0:26
reaction to the myelin basic protein.
0:29
So it's an autoimmune disorder,
0:31
and you may have both brain and spine lesions.
0:33
There is a hemorrhagic aggressive form that only
0:36
occurs in the brain, not in the spinal cord.
0:39
Where does ADEM occur? As you can see,
0:42
predominantly in the brain.
0:45
However, the cord lesions occur in 50% of patients who
0:51
are children and 10% of adult lesions, so
0:55
much more likely to occur in the brain.
0:57
But you may see manifestations in the cord
1:00
in children after viral illnesses.
1:04
The typical ADEM appearance in the brain shows
1:08
both white matter confluent lesions, as well as
1:11
deep gray matter lesions, distinguishing
1:14
it from multiple sclerosis.
1:17
And these lesions may or may not
1:19
show contrast enhancement.
1:22
As I mentioned, sometimes you will have multiphasic
1:25
disseminated encephalomyelitis,
1:28
and this may be a precursor to the development
1:33
as an adult of multiple sclerosis.
Summary of Acute Disseminated Encephalomyelitis
HIDEInteractive Transcript
0:00
When considering intradural intramedullary
0:03
lesions in children,
0:04
we should consider the possibility of ADEM.
0:07
Remember that this was originally described as a
0:11
monophasic disease, but we now know that it,
0:13
too, may be polyphasic.
0:15
It occurs classically two to four weeks after
0:17
viral illnesses, most commonly,
0:20
immunizations, much less commonly.
0:23
It is a delayed type hypersensitivity type IV
0:26
reaction to the myelin basic protein.
0:29
So it's an autoimmune disorder,
0:31
and you may have both brain and spine lesions.
0:33
There is a hemorrhagic aggressive form that only
0:36
occurs in the brain, not in the spinal cord.
0:39
Where does ADEM occur? As you can see,
0:42
predominantly in the brain.
0:45
However, the cord lesions occur in 50% of patients who
0:51
are children and 10% of adult lesions, so
0:55
much more likely to occur in the brain.
0:57
But you may see manifestations in the cord
1:00
in children after viral illnesses.
1:04
The typical ADEM appearance in the brain shows
1:08
both white matter confluent lesions, as well as
1:11
deep gray matter lesions, distinguishing
1:14
it from multiple sclerosis.
1:17
And these lesions may or may not
1:19
show contrast enhancement.
1:22
As I mentioned, sometimes you will have multiphasic
1:25
disseminated encephalomyelitis,
1:28
and this may be a precursor to the development
1:33
as an adult of multiple sclerosis.
Report
Description
Faculty
David M Yousem, MD, MBA
Professor of Radiology, Vice Chairman and Associate Dean
Johns Hopkins University
Tags
Spine
Pediatrics
Non-infectious Inflammatory
Neuroradiology
Musculoskeletal (MSK)
MRI
Idiopathic
Brain
Acquired/Developmental
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