Sequential Magnetic Resonance Imaging Finding of Intramedullary Spinal Cord Abscess including Diffusion Weighted Image: a Case Report

Abstract A patient with traumatic thoracic intramedullary hematoma underwent operation 1 month postinjury. Evacuation and syringosubarachnoid shunting resulted in return of bladder control and of sufficient strength in the lower extremities to permit independent walking. The outcome is discussed in light of the literature on traumatic intramedullary hematoma. The value of magnetic resonance imaging is noted. We suggest an aggressive diagnostic and therapeutic approach toward intramedullary spinal cord hematomas.

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Bamboo Leaf Sign as a Sensitive Magnetic Resonance Imaging Finding in Spinal Subependymoma: Case Report and Literature Review

Case Reports in Neurological Medicine ◽

10.1155/2016/9108641 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6

Author(s):

Hiroyuki Toi ◽

Yukari Ogawa ◽

Keita Kinoshita ◽

Satoshi Hirai ◽

Hiroki Takai ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Spinal Cord ◽

Magnetic Resonance ◽

Imaging Finding ◽

Radiological Finding ◽

Magnetic Resonance Imaging Finding ◽

World Health ◽

Resonance Imaging ◽

Characteristic Appearance ◽

Spinal Mri

Background and Importance. Subependymoma occurs very rarely in the spinal cord. We report another case of spinal subependymoma along with a review of the literature and discussion of a radiological finding that is useful for preoperative diagnosis of this tumor.Clinical Presentation. A 51-year-old man presented with a 2-year history of progressive muscle weakness in the right lower extremity. Sagittal magnetic resonance imaging (MRI) showed spinal cord expansion at the Th7–12 vertebral level. Surgical resection was performed and the tumor was found to involve predominantly subpial growth. Histological diagnosis was subependymoma, classified as Grade I according to criteria of World Health Organization. We made an important discovery of what seems to be a characteristic appearance for spinal subependymoma on sagittal MRI. Swelling of the spinal cord is extremely steep, providing unusually large fusiform dilatation resembling a bamboo leaf. We have termed this characteristic MRI appearance as the “bamboo leaf sign.” This characteristic was apparent in 76.2% of cases of spinal subependymoma for which MRI findings were reported.Conclusion. The bamboo leaf sign on spinal MRI is useful for differentiating between subependymoma and other intramedullary tumors. Neurosurgeons encountering the bamboo leaf sign on spinal MRI should consider the possibility of subependymoma.

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Late-onset cauda equina contrast enhancement: a rare magnetic resonance imaging finding in subacute spinal cord infarction

The Spine Journal ◽

10.1016/j.spinee.2014.08.003 ◽

2014 ◽

Vol 14 (12) ◽

pp. 3065-3066 ◽

Cited By ~ 3

Author(s):

Emanuele Pravatà ◽

Carlo Cereda ◽

Alejandro Gabutti ◽

Daniela Distefano ◽

Alessandro Cianfoni

Keyword(s):

Magnetic Resonance Imaging ◽

Spinal Cord ◽

Magnetic Resonance ◽

Contrast Enhancement ◽

Late Onset ◽

Imaging Finding ◽

Magnetic Resonance Imaging Finding ◽

Cauda Equina ◽

Spinal Cord Infarction ◽

Resonance Imaging

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Multisession CyberKnife Radiosurgery for Intramedullary Spinal Cord Arteriovenous Malformations

Neurosurgery ◽

10.1227/01.neu.0000215891.25153.ba ◽

2006 ◽

Vol 58 (6) ◽

pp. 1081-1089 ◽

Cited By ~ 89

Author(s):

John Sinclair ◽

Steven D. Chang ◽

Iris C. Gibbs ◽

John R. Adler

Keyword(s):

Magnetic Resonance Imaging ◽

Spinal Cord ◽

Magnetic Resonance ◽

Arteriovenous Malformations ◽

Conus Medullaris ◽

Spinal Angiography ◽

Resonance Imaging ◽

Intramedullary Spinal Cord ◽

Cyberknife Radiosurgery

Abstract OBJECTIVE: Intramedullary spinal cord arteriovenous malformations (AVMs) have an unfavorable natural history that characteristically involves myelopathy secondary to progressive ischemia and/or recurrent hemorrhage. Although some lesions can be managed successfully with embolization and surgery, AVM size, location, and angioarchitecture precludes treatment in many circumstances. Given the poor outlook for such patients, and building on the successful experience with radiosurgical ablation of cerebral AVMs, our group at Stanford University has used CyberKnife (Accuray, Inc., Sunnyvale, CA) stereotactic radiosurgery (SRS) to treat selected spinal cord AVMs since 1997. In this article, we retrospectively analyze our preliminary experience with this technique. METHODS: Fifteen patients with intramedullary spinal cord AVMs (nine cervical, three thoracic, and three conus medullaris) were treated by image-guided SRS between 1997 and 2005. SRS was delivered in two to five sessions with an average marginal dose of 20.5 Gy. The biologically effective dose used in individual patients was escalated gradually over the course of this study. Clinical and magnetic resonance imaging follow-up were carried out annually, and spinal angiography was repeated at 3 years. RESULTS: After a mean follow-up period of 27.9 months (range, 3–59 mo), six of the seven patients who were more than 3 years from SRS had significant reductions in AVM volumes on interim magnetic resonance imaging examinations. In four of the five patients who underwent postoperative spinal angiography, persistent AVM was confirmed, albeit reduced in size. One patient demonstrated complete angiographic obliteration of a conus medullaris AVM 26 months after radiosurgery. There was no evidence of further hemorrhage after CyberKnife treatment or neurological deterioration attributable to SRS. CONCLUSION: This description of CyberKnife radiosurgical ablation demonstrates its feasibility and apparent safety for selected intramedullary spinal cord AVMs. Additional experience is necessary to ascertain the optimal radiosurgical dose and ultimate efficacy of this technique.

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Functional Magnetic Resonance Imaging: A Potential Tool for the Evaluation of Spinal Cord Stimulation: Technical Case Report

Neurosurgery ◽

10.1097/00006123-199708000-00042 ◽

1997 ◽

Vol 41 (2) ◽

pp. 501-504 ◽

Cited By ~ 49

Author(s):

Kiriakopoulos Elaine T. ◽

Ronald R. Tasker ◽

Sera Nicosia ◽

Wood Michael L. ◽

David J. Mikulis

Keyword(s):

Magnetic Resonance Imaging ◽

Spinal Cord ◽

Case Report ◽

Magnetic Resonance ◽

Functional Magnetic Resonance Imaging ◽

Spinal Cord Stimulation ◽

Functional Magnetic Resonance ◽

Resonance Imaging ◽

Potential Tool

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A Survey of 65 Tumors within the Spinal Cord: Surgical Results and the Importance of Preoperative Magnetic Resonance Imaging

Neurosurgery ◽

10.1227/00006123-199111000-00002 ◽

1991 ◽

Vol 29 (5) ◽

pp. 651-657 ◽

Cited By ~ 82

Author(s):

Jacques Brotchi ◽

Olivier Dewitte ◽

Danielle Balériaux ◽

Arlette Vandesteene ◽

Christian Raftopoulos ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Spinal Cord ◽

Magnetic Resonance ◽

Surgical Results ◽

Resonance Imaging ◽

Intramedullary Spinal Cord ◽

Cavitron Ultrasonic Surgical Aspirator ◽

Highly Sensitive ◽

Previously Treated ◽

Ultrasonic Surgical Aspirator

Abstract Between January 1984 and December 1990. 65 intramedullary spinal cord tumors were diagnosed and operated on. In this series, all patients underwent magnetic resonance imaging investigations and were operated on with the Cavitron ultrasonic surgical aspirator whenever necessary. Major surgical difficulties have been found in patients previously treated by radiotherapy with or without biopsy. We found magnetic resonance imaging to be a highly sensitive imaging procedure and the method of choice for visualizing tumors within the spinal cord. Nevertheless, accurate diagnosis may only be suggested by magnetic resonance imaging, rather than made definitively. Surgery is necessary in every case in order to obtain a definite diagnosis. Radical surgery can be performed when a plane exists between the tumor and the normal spinal cord: biopsy or debulking with the Cavitron ultrasonic surgical aspirator should be performed when the tumor is infiltrative. We have performed 33 so-called total resections, 22 partial resections, and 10 biopsies, among which 5 were performed on lipomas. Surgical results were assessed at 3 months after surgery, showing 35 improvements (53%), 24 stabilizations (37%), and 6 deteriorations (10%).

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