Spinal Epidural Lipomatosis Associated with Intrathecal Flow Voids: Demonstration of Engorged Veins Using Flat Panel Catheter Angiotomography

Magnetic Resonance ◽

Resonance Imaging ◽

Venous Plexus ◽

Flat Panel ◽

Epidural Lipomatosis ◽

Spinal Epidural ◽

Venous Disorders

AbstractWe present a case of a 54-year-old male with spinal epidural lipomatosis who had associated flow voids on magnetic resonance imaging with dilated intrathecal vessels. During spinal angiogram, 20s DynaCT (flat panel catheter angiotomography) was utilized to demonstrate the intrathecal engorged veins. Venous engorgement of epidural venous plexus has been previously described in epidural lipomatosis; however, dilated intrathecal perimedullary veins have not been demonstrated by imaging. We have described the utility of flat panel catheter angiotomography in understanding venous disorders in such patients.

Spinal Epidural Lipomatosis in Lumbar Magnetic Resonance Imaging Scans

Orthopedics ◽

10.3928/01477447-20140401-57 ◽

2014 ◽

Vol 37 (4) ◽

pp. e362-e366 ◽

Cited By ~ 12

Author(s):

Hisashi Sugaya ◽

Toshikazu Tanaka ◽

Takeshi Ogawa ◽

Hajime Mishima

Keyword(s):

Magnetic Resonance ◽

Resonance Imaging ◽

Epidural Lipomatosis ◽

The prevalence of spinal epidural lipomatosis on magnetic resonance imaging

The Spine Journal ◽

10.1016/j.spinee.2017.02.010 ◽

2017 ◽

Vol 17 (7) ◽

pp. 969-976 ◽

Cited By ~ 14

Author(s):

Nina C. Theyskens ◽

Nuno Rui Paulino Pereira ◽

Stein J. Janssen ◽

Christopher M. Bono ◽

Joseph H. Schwab ◽

...

Keyword(s):

Magnetic Resonance ◽

Resonance Imaging ◽

Epidural Lipomatosis ◽

Radiographic Prevalence and Predisposing Factors Associated with Finding Spinal Epidural Lipomatosis on Magnetic Resonance Imaging

The Spine Journal ◽

10.1016/j.spinee.2016.07.107 ◽

2016 ◽

Vol 16 (10) ◽

pp. S198-S199

Author(s):

Nuno Rui Paulino Pereira ◽

Nina Theyskens ◽

Stein Janssen ◽

Bianca Verbeek ◽

Joseph H. Schwab ◽

...

Keyword(s):

Magnetic Resonance ◽

Predisposing Factors ◽

Resonance Imaging ◽

Epidural Lipomatosis ◽

Factors Associated ◽

Comparison of relative and absolute values of magnetic resonance imaging in the diagnosis of spinal epidural lipomatosis

Journal of Spinal Cord Medicine ◽

10.1080/10790268.2018.1449782 ◽

2018 ◽

Vol 42 (4) ◽

pp. 502-507

Author(s):

Yuxi Ge ◽

Xiaohan Yang ◽

Yaqian You ◽

Yinghua Xuan ◽

Gen Yan

Keyword(s):

Magnetic Resonance ◽

Resonance Imaging ◽

Epidural Lipomatosis ◽

Decompression of idiopathic lumbar epidural lipomatosis: diagnostic magnetic resonance imaging evaluation and review of the literature

Journal of Neurosurgery Spine ◽

10.3171/spi.2006.4.1.24 ◽

2006 ◽

Vol 4 (1) ◽

pp. 24-30 ◽

Cited By ~ 34

Author(s):

Yoshinori Ishikawa ◽

Yoichi Shimada ◽

Naohisa Miyakoshi ◽

Tetsuya Suzuki ◽

Michio Hongo ◽

...

Keyword(s):

Magnetic Resonance ◽

Clinical Symptoms ◽

Symptomatic Relief ◽

Japanese Orthopaedic Association ◽

Neurological Deficits ◽

Resonance Imaging ◽

Epidural Lipomatosis ◽

Epidural Fat ◽

Object Idiopathic symptomatic spinal epidural lipomatosis (SEL) is a rare condition, and few reports have discussed diagnostic imaging criteria. To evaluate factors relating to its clinical symptoms, correlations between clinical features and the presence of spinal epidural fat were investigated, and the literature concerning idiopathic SEL was reviewed. Methods Morphological gradings of epidural fat were evaluated in seven patients with idiopathic SEL by using magnetic resonance (MR) imaging. In addition, body mass index (BMI), the number of involved vertebral levels, grade, and preoperative Japanese Orthopaedic Association (JOA) score were analyzed. Surgery resulted in symptomatic relief, with a mean JOA score recovery rate of 67.4%. Grading of epidural fat tended to display a slight negative correlation with preoperative JOA score, whereas a strong significant positive correlation was found between the number of involved vertebral levels and BMI. Conclusions The number of involved vertebral levels and obesity are strongly correlated, whereas severity of dural compression is not always significantly associated with neurological complications. These results indicate that epidural fat of the lumbar spine contributes to neurological deficits. In addition, weight-reduction therapy appears to decrease the number of vertebral levels involved. Magnetic resonance imaging–based grading is helpful for the diagnosis and evaluation of idiopathic lumbar SEL. Moreover, symptoms and neurological findings are important for determining the surgical approach.

Magnetic resonance imaging-monitored conservative management of traumatic spinal epidural hematomas

Neurosurgical FOCUS ◽

10.3171/foc.1999.6.1.9 ◽

1999 ◽

Vol 6 (1) ◽

pp. E8 ◽

Cited By ~ 3

Author(s):

Giovanni La Rosa ◽

Domenico d'Avella ◽

Alfredo Conti ◽

Salvatore Cardali ◽

Domenico La Torre ◽

...

Keyword(s):

Magnetic Resonance ◽

Nonsurgical Treatment ◽

Spine Injury ◽

Real Spectrum ◽

Mri Imaging ◽

Resonance Imaging ◽

Traumatic Injuries ◽

Lumbar Vertebral Body ◽

Spinal epidural hematomas (SEHs) are uncommon complications caused by traumatic injuries to the spine. Emergency surgical evacuation is the standard treatment. Although recognized in the literature, the possibility of nonsurgical treatment of traumatic SEHs is far from being codified. The authors report on the treatment of four patients whose traumatic SEHs were diagnosed by magnetic resonance (MRI) imaging and managed conservatively with excellent results. All patients had suffered severe spine injury with fracture of a lumbar vertebral body, were admitted within 12 hours of trauma, and exhibited only minimal neurological disturbances on admission. Magnetic resonance imaging studies were performed within 24 hours of trauma. Hematomas appeared isointense/slightly hyperintense on T1- and heterogeneous on T2-weighted MR images. Clot thickness varied between 0.8 cm and 1 cm, width between 1 cm and 1.8 cm, and length between 2.7 and 9 cm. In light of each patient's fairly good neurological condition a conservative approach was taken. In all cases serial MR imaging documented progressive clot resolution, which was completed within 8 to 10 days of trauma. At discharge all patients were neurologically intact. The conservative treatment option of traumatic SEH should be reserved for exceptional cases whose deficits are minimal, when neurological deterioration is followed by early and sustained spontaneous recovery, and when there are clear medical contraindications for surgery. The results of the present study confirm that nonsurgical treatment is feasible in a subgroup of minimally symptomatic patients who harbor moderate-sized SEHs. Although the authors' experience shows a good spontaneous outcome of some traumatic SEH, further studies are necessary to understand the real spectrum of nonsurgical treatment of such lesions.

Pure epidural spinal cavernous haemangioma

Surgical Neurology International ◽

10.25259/sni_805_2021 ◽

2021 ◽

Vol 12 ◽

pp. 523

Author(s):

Ragavan Manoharan ◽

Jonathon Parkinson

Keyword(s):

Magnetic Resonance ◽

Surgical Excision ◽

Cavernous Haemangioma ◽

Case Description ◽

Resonance Imaging ◽

Cavernous Hemangiomas ◽

The Right ◽

Spinal Epidural ◽

Progressive Paraparesis

Background: Pure epidural spinal cavernous hemangiomas (SCH) account for only 4% of all spinal epidural lesions. Our literature review identified 61 publications reporting on, a total of 175 cases in the magnetic resonance imaging era. Here, we reviewed those cases, and have added our case of what appeared to be a multifocal SCH. Case Description: A 72-year-old male presented with a progressive paraparesis attributed to a T5/T6 dorsolateral extradural mass extending into the right T5/6 foramen. Surgical excision documented the lesion, histologically, was a SCH. A second similar lesion was noted involving the left C7/T1 foramen; as the patient was asymptomatic from this lesion, and no additional biopsy was performed. The patient returned to normal neurological function within 2 months postoperatively. Conclusions: Here, a 72-year-old male presented with a pathologically confirmed T5/T6 epidural SCH and a secondary C7/T1 foraminal lesion suspected to represent a secondary focus of an epidural SCH.