Spinal intramedullary cavernoma: clinical presentation and surgical outcome

2000 ◽  
Vol 93 (1) ◽  
pp. 65-70 ◽  
Author(s):  
Harel Deutsch ◽  
George I. Jallo ◽  
Alina Faktorovich ◽  
Fred Epstein
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Signs And Symptoms ◽  
Acute Onset ◽  
Surgical Removal ◽  
Resonance Imaging ◽  
Content Type ◽  
Posterior Laminectomy ◽  
Fine Print

Object. Improved neuroimaging techniques have led to an increase in the reported cases of intramedullary cavernomas. The purpose of this study was to define the spectrum of presenting signs and symptoms in patients with spinal intramedullary cavernomas and to analyze the role of surgery as a treatment for these lesions. Methods. The authors reviewed the charts of 16 patients who underwent surgery for spinal intramedullary cavernomas. All patients underwent preoperative magnetic resonance imaging studies. Cavernomas represented 14 (5.0%) of 280 intramedullary lesions found in adults and two (1.1%) of 181 intramedullary lesions found in pediatric cases. A posterior laminectomy and surgical resection of the malformation were performed in all 16 patients. Conclusions. Magnetic resonance imaging is virtually diagnostic for spinal cavernoma lesions. Patients with spinal intramedullary cavernomas presented with either an acute onset of neurological compromise or a slowly progressive neurological decline. Acute neurological decline occurs secondary to hemorrhage within the spinal cord. Chronic progressive myelopathy occurs due to microhemorrhages and the resulting gliotic reaction to hemorrhagic products. There is no evidence that cavernomas increase in size. The rate of rebleeding is unknown, but spinal cavernomas appear to be clinically more aggressive than cranial cavernomas, probably because the spinal cord is less tolerant of mass lesions. Complete surgical removal of the cavernoma was possible in 15 of 16 of the authors' cases.

Magnetic resonance imaging findings in ossification of the posterior longitudinal ligament of the cervical spine

1998 ◽  
Vol 88 (2) ◽  
pp. 247-254 ◽  
Author(s):  
Izumi Koyanagi ◽  
Yoshinobu Iwasaki ◽  
Kazutoshi Hida ◽  
Hiroyuki Imamura ◽  
Hiroshi Abe
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Mr Imaging ◽  
Posterior Longitudinal Ligament ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Disc Protrusion ◽  
Content Type ◽  
Fine Print

Object. Because of the lack of magnetic resonance (MR) signal from cortical bones, MR imaging is inadequate for diagnosing ossified lesions in the spinal canal. However, MR imaging provides important information on spinal cord morphology and associated soft-tissue abnormality. The purpose of this study is to determine the role of MR imaging in the diagnosis and treatment of patients with ossification of the posterior longitudinal ligament (OPLL) of the cervical spine. Methods. The authors reviewed MR imaging findings in 42 patients with cervical OPLL who were examined with a superconducting MR imaging system. The types of OPLL reviewed included eight cases of continuous, 21 cases of segmental, and 13 cases of the mixed type. All patients were treated surgically either by anterior (26 cases) or posterior decompression (16 cases). Conclusions. The T1-weighted images clearly demonstrated the spinal cord deformity caused by OPLL. Associated disc protrusion was found to be present at the maximum compression level in 60% of the patients in this series. The highest incidence of disc protrusion (81%) was found in patients with segmental OPLL. Intramedullary hyperintensity on T2*-weighted imaging was noted in 18 patients (43%). The neurological deficits observed in these 18 patients were significantly more severe than those observed in the other 24 patients. Postoperative MR imaging revealed improvement in the spinal cord deformity, although the intramedullary hyperintensity was still observed in most cases. The present study demonstrates the importance of associated disc protrusion in the development of myelopathy in patients with cervical OPLL. Magnetic resonance imaging findings may be used to help determine the actual levels of spinal cord compression and to suggest the method of surgical treatment.

Magnetic resonance imaging of spinal meningiomas and neurinomas

1987 ◽  
Vol 66 (5) ◽  
pp. 695-700 ◽  
Author(s):  
Gerhard Schroth ◽  
Armin Thron ◽  
Lothar Guhl ◽  
Karsten Voigt ◽  
Hans-Peter Niendorf ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Spinal Tumors ◽  
Resonance Imaging ◽  
Content Type ◽  
Spinal Cord Diseases ◽  
Spinal Meningiomas ◽  
Magnetic Resonance Imaging Mri ◽  
Fine Print

The detection and delineation of spinal tumors by magnetic resonance imaging (MRI) after intravenous administration of gadolinium (Gd)-diethylenetriaminepenta-acetic acid (DTPA) is demonstrated in eight cases of neurinoma or meningioma. The advantages of Gd-DTPA-enhanced MRI over other MRI techniques used in more than 100 cases of spinal cord diseases are described.

Direct convective delivery of macromolecules to the spinal cord

1998 ◽  
Vol 89 (4) ◽  
pp. 616-622 ◽  
Author(s):  
Russell R. Lonser ◽  
Nitin Gogate ◽  
Paul F. Morrison ◽  
J. David Wood ◽  
Edward H. Oldfield
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Histological Analysis ◽  
Quantitative Autoradiography ◽  
Homogeneous Distribution ◽  
Outer Diameter ◽  
Resonance Imaging ◽  
Content Type ◽  
Fine Print

Object. Because of the limited penetration of macromolecules across the blood—spinal cord barrier, numerous therapeutic compounds with potential for treating spinal cord disorders cannot be used effectively. The authors have developed a technique to deliver and distribute macromolecules regionally in the spinal cord by using convection in the interstitial space. Methods. The authors designed a delivery system connected to a “floating” silica cannula (inner diameter 100 µm, outer diameter 170 µm) that provides for constant volumetric inflow to the spinal cord. A solution containing albumin that was either unlabeled or labeled with carbon-14 or gadolinium was infused at various volumes (3, 6, 10, 20, 40, or 50 µl) at a rate of 0.1 µl/minute into the spinal cord dorsal columns of nine swine and into the lateral columns of three primates (Macaca mulatta). Volume of distribution (Vd), concentration homogeneity, and percentage of recovery were determined using scintillation analysis, kurtosis calculation (K), and quantitative autoradiography (six swine), magnetic resonance imaging (one swine and three primates), and histological analysis (all animals). Neurological function was observed for up to 3 days in four of the swine and up to 16 weeks in the three primates. The Vd of 14C-albumin was linearly proportional (R2 = 0.97) to the volume of infusion (Vi) (Vd/Vi = 4.4 ± 0.5; [mean ± standard deviation]). The increases in Vd resulting from increases in Vi were primarily in the longitudinal dimension (R2 = 0.83 in swine; R2 = 0.98 in primates), allowing large segments of spinal cord (up to 4.3 cm; Vi 50 µl) to be perfused with the macromolecule. The concentration across the area of distribution was homogeneous (K = −1.1). The mean recovery of infused albumin from the spinal cord was 85.5 ± 5.6%. Magnetic resonance imaging and histological analysis combined with quantitative autoradiography revealed the albumin infusate to be preferentially distributed along the white matter tracts. No animal exhibited a neurological deficit as a result of the infusion. Conclusions. Regional convective delivery provides reproducible, safe, region-specific, and homogeneous distribution of macromolecules over large longitudinal segments of the spinal cord. This delivery method overcomes many of the obstacles associated with current delivery techniques and provides for research into new treatments of various conditions of the spinal cord.

Myelopathy due to epidural varicose veins of the cervicothoracic junction

1988 ◽  
Vol 69 (6) ◽  
pp. 940-941 ◽  
Author(s):  
Curtis A. Dickman ◽  
Joseph M. Zabramski ◽  
Volker K. H. Sonntag ◽  
Stephen Coons
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Varicose Veins ◽  
Signs And Symptoms ◽  
Cord Compression ◽  
Resonance Imaging ◽  
Cervicothoracic Junction ◽  
Content Type ◽  
Spinal Epidural ◽  
Fine Print

✓ A 30-year-old man presented with a subacute course of myelopathic signs and symptoms. Magnetic resonance imaging demonstrated an epidural mass lesion of the spinal canal at the cervicothoracic junction causing compression of the spinal cord. Laminectomy with resection of this lesion revealed a large varix with acute and chronic thrombus. Postoperatively, an improvement in neurological function occurred. Spinal epidural varicosities have been reported as an etiological factor in lumbar and sacral radiculopathies. This is the first reported case of spinal cord compression in association with spinal epidural varices. The diagnosis, pathophysiology, and management of this disorder are presented.

Magnetic resonance imaging correlation in pediatric spinal cord injury without radiographic abnormality

2002 ◽  
Vol 97 (1) ◽  
pp. 33-39 ◽  
Author(s):  
Amos O. Dare ◽  
Mark S. Dias ◽  
Veetai Li
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Mr Imaging ◽  
Neurological Deficits ◽  
Resonance Imaging ◽  
Content Type ◽  
Cord Injury ◽  
Frankel Grade ◽  
Fine Print

Object. The authors conducted a study to determine correlations between clinical syndromes and early magnetic resonance (MR) imaging—documented findings in children with spinal cord injury without radiographic abnormality (SCIWORA). Methods. The authors retrospectively reviewed the records obtained in 20 patients who presented with SCIWORA to the Children's Hospital of Buffalo between 1992 and 1999. Initial neurological syndromes, subsequent hospital course and outcome, and early MR imaging findings obtained using conventional sequences on a 1.5-tesla unit were recorded. Neurological syndromes on presentation were complete (Frankel Grade A) in two patients (10%), severe partial (Frankel Grade C) in one patient (5%), and mild partial (Frankel Grade D) in 17 patients (85%). Partial neurological deficits resolved in 14 (78%) of 18 patients within 72 hours and lasted more than 72 hours in four patients (22%). Magnetic resonance imaging was performed in both patients presenting with complete injuries and in 17 of 18 patients presenting with partial neurological deficits. The studies were obtained within 24 hours in 17 patients (85%). Neuroimaging revealed spinal cord swelling at the cervical level in one of the children with complete injury and cord edema with associated hemorrhage at cervical and thoracic levels in the other. Neural and extraneural elements were shown to be normal in all 17 patients with partial injuries who underwent MR imaging, including in the four patients with partial motor deficits lasting more than 72 hours. Conclusions. In this series, the predominant neurological presentation of SCIWORA was a mild, partial syndrome that resolved within 72 hours. Magnetic resonance imaging revealed abnormal features only in those patients with complete neurological deficits. These findings suggest that in the acute setting conventional MR imaging sequences may lack the sensitivity to demonstrate neural and extraneural abnormalities associated with partial or temporary neurological deficits of SCIWORA, even when those deficits persist beyond 72 hours.

Optic pathway glioma infiltrating into somatostatinergic pathways in a young boy with gigantism

1994 ◽  
Vol 81 (4) ◽  
pp. 595-600 ◽  
Author(s):  
Thomas J. Manski ◽  
Charles S. Ha worth ◽  
Bertrand J. Duval-Arnould ◽  
Elisabeth J. Rushing
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Optic Pathway Glioma ◽  
Optic Pathway ◽  
Resonance Imaging ◽  
Content Type ◽  
Hyperintense Signal ◽  
Immunocytochemical Studies ◽  
Stereotactic Biopsies ◽  
Fine Print

✓ The authors report gigantism in a 16-month-old boy with an extensive optic pathway glioma infiltrating into somatostatinergic pathways, as revealed by magnetic resonance imaging and immunocytochemical studies. Stereotactic biopsies of areas showing hyperintense signal abnormalities on T2-weighted images in and adjacent to the involved visual pathways provided rarely obtained histological correlation of such areas. The patient received chemotherapy, which resulted in reduction of size and signal intensity of the tumor and stabilization of vision and growth velocity.

Magnetic resonance imaging of spinal arteriovenous malformations

1987 ◽  
Vol 66 (6) ◽  
pp. 830-834 ◽  
Author(s):  
John L. Doppman ◽  
Giovanni Di Chiro ◽  
Andrew J. Dwyer ◽  
Joseph L. Frank ◽  
Edward H. Oldfield
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Arteriovenous Malformations ◽  
High Signal ◽  
Resonance Imaging ◽  
Content Type ◽  
Spinal Arteriovenous Malformations ◽  
Magnetic Resonance Imaging Mri ◽  
Spinal Avm ◽  
Fine Print

✓ Magnetic resonance imaging (MRI) was performed on 12 patients with spinal arteriovenous malformations (AVM's). Six lesions were intramedullary, five were dural, and one was in a posterior extramedullary location. Serpentine filling defects similar to the classic myelographic findings were demonstrated within the high-signal cerebrospinal fluid on T2-weighted coronal scans. The intramedullary nidus was identified by MRI as an area of low-signal intensity within the cord in all six intramedullary AVM's. Neither the dural nor the posterior extramedullary lesions showed intramedullary components. It is concluded that MRI may noninvasively provide the initial diagnosis of a spinal AVM and distinguish intramedullary from dural and extramedullary lesions.

Optic nerve ganglioglioma

1993 ◽  
Vol 78 (6) ◽  
pp. 979-982 ◽  
Author(s):  
William Y. Lu ◽  
Marc Goldman ◽  
Byron Young ◽  
Daron G. Davis
Keyword(s):  
Magnetic Resonance Imaging ◽  
Nervous System ◽  
Optic Nerve ◽  
Magnetic Resonance ◽  
Visual Field ◽  
Resonance Imaging ◽  
Optic Nerve Glioma ◽  
Content Type ◽  
Visual Field Deficit ◽  
Fine Print

✓ Gangliogliomas of the optic nerve are extremely rare. The case is reported of a 38-year-old man who presented with a visual field deficit and was discovered to have an optic nerve ganglioglioma. The possible embryological origins of this neoplasm, its histological and immunohistochemical features, and its appearance on magnetic resonance imaging are examined. The prognoses of optic nerve glioma and of gangliogliomas occurring elsewhere in the nervous system are compared.

Correlation of the relationships of brain—tumor interfaces, magnetic resonance imaging, and angiographic findings to predict cleavage of meningiomas

1999 ◽  
Vol 91 (3) ◽  
pp. 384-390 ◽  
Author(s):  
Faruk İldan ◽  
Metin Tuna ◽  
Alp İskender Göcer ◽  
Bülent Boyar ◽  
Hüseyin Bağdatoğlu ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Brain Tumor ◽  
Magnetic Resonance ◽  
Mr Imaging ◽  
Vascular Supply ◽  
Peritumoral Edema ◽  
Resonance Imaging ◽  
Content Type ◽  
Angiographic Findings ◽  
Fine Print

Object. The authors examined the relationships of brain—tumor interfaces, specific magnetic resonance (MR) imaging features, and angiographic findings in meningiomas to predict tumor cleavage and difficulty of resection.Methods. Magnetic resonance imaging studies, angiographic data, operative reports, clinical data, and histopathological findings were examined retrospectively in this series, which included 126 patients with intracranial meningiomas who underwent operations in which microsurgical techniques were used. The authors have identified three kinds of brain—tumor interfaces characterized by various difficulties in microsurgical dissection: smooth type, intermediate type, and invasive type. The signal intensity on T1-weighted MR images was very similar regardless of the type of brain—tumor interface (p > 0.1). However, on T2-weighted images the different interfaces seemed to correlate very precisely with the signal intensity and the amount of peritumoral edema (p < 0.01), allowing the prediction of microsurgical effort required during surgery. On angiographic studies, the pial—cortical arterial supply was seen to participate almost equally with the meningeal—dural arterial supply in vascularizing the tumor in 57.9% of patients. Meningiomas demonstrating hypervascularization on angiography, particularly those fed by the pial—cortical arteries, exhibited significantly more severe edema compared with those supplied only from meningeal arteries (p < 0.01). Indeed, a positive correlation was found between the vascular supply from pial—cortical arteries and the type of cleavage (p < 0.05).Conclusions. In this analysis the authors proved that there is a strong correlation between the amount of peritumoral edema, hyperintensity of the tumor on T2-weighted images, cortical penetration, vascular supply from pial—cortical arteries, and cleavage of the meningioma. Therefore, the consequent difficulty of microsurgical dissection can be predicted preoperatively by analyzing MR imaging and angiographic studies.

Intracranial chondroma in a patient with Ollier's disease

1989 ◽  
Vol 70 (2) ◽  
pp. 274-276 ◽  
Author(s):  
Robert F. Traflet ◽  
Ashok R. Babaria ◽  
Giancarlo Barolat ◽  
H. T. Doan ◽  
Carlos Gonzalez ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Computerized Tomography ◽  
Diagnostic Value ◽  
Resonance Imaging ◽  
Content Type ◽  
Ollier’S Disease ◽  
Intracranial Chondroma ◽  
Ollier's Disease ◽  
Fine Print

✓ A case is presented in which a solitary chondroma arose from the clivus of a patient with Ollier's disease. These tumors are rare. The diagnostic value of computerized tomography and magnetic resonance imaging is discussed.

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