A1 and B1 reprinted which have permission out-of Kumar N
A and you can B, Axial (A) and coronal postcontrast (B) T1-weighted MR photos out of someone that have SS let you know diffuse pachymeningeal enhancement farmersonly similar to you to definitely said in patients having craniospinal hypotension. (exact same diligent because found from inside the 11A1 and you can A2). C, Axial CT always check out of an individual which have SS suggests improved attenuation inside the pons due to assumed calcification of the hemosiderin deposition. Superficial siderosis and you may CSF hypovolemia: new problem (dural) on hook up. Neurology 2007;–26 (Copyright 2007, Wolters Kluwer Fitness).
B1 and you may B2, Involved sagittal (reformatted) (B1) and axial (B2) postmyelography CT photos have shown opacification of one’s ventral epidural fluid from the intrathecal examine for the same education as the CSF, thus guaranteeing a dynamic drip
An indirect idea on etiology from SS is generally clear on MR imaging. A fluid-filled intraspinal hole regarding variable dimension can often be viewed (Fig 4A, -C1 and you can C2, D?G; Fig 6A1 and you can A2, B1 and you can B2; Fig 7A1 and you may A2; and additionally viewed with the CT myelogram when you look at the Fig 7B1 and you may B2 and Fig 10A). 2,step three,twenty-eight –29,35,thirty six Barely the newest liquid-occupied hole is generally intracranial (Fig 4B). 43 These types of local water-filled cavities was in fact variably described as meningoceles, pseudomeningoceles, diverticula, pseudoencephalocele, epidural cyst, or maybe just while the “water series.” Courage supply avulsions, will in association with brachial plexus injury and pseudomeningoceles, try a typically reported association. dos,10,eleven,14,17,twenty-seven,44 A disturbance regarding the circumferential hypointensity on axial T2-weighted MR imaging may indicate options avulsion and that’s possibly owed so you’re able to lack of the fresh pia mater from the avulsion site (Fig 8A; and additionally seen to the an effective CT myelogram into the Fig 10C). 27 Evidence of bony burns off (Fig 8C; and additionally viewed towards CT examine into the Fig 10B), myelomalacia (Fig 8D), or cord tethering (Fig 4F) can be establish. Others understood sourced elements of bleeding inside people with SS have typically incorporated neoplasms and you can vascular malformations. Mental amyloid angiopathy can certainly be of the proof of hemosiderin deposition the same as that present in SS (Fig 8E). 45
Good and you will B, Pre- (A1 and you will A2) and you will postoperative (B1 and B2) sagittal (A1 and you will B1) and you may axial (A2 and you will B2) T2-adjusted MR photos regarding someone which have SS inform you a serious reduced total of a longitudinally thorough water-occupied collection anterior into the spinal cord immediately after fix regarding a good dural defect from the T11. Your website of dural problem try surrounding because of the a dynamic CT myelogram. Superficial siderosis: associations and therapeutic effects. Arch Neurol 2007;–96 (Copyright 2007, American Medical Relationship).
A1 and you may A2, Sagittal (A1) and you may axial (A2) T2-weighted MR images regarding a patient having SS reveal a great cervicothoracic epidural liquid-occupied collection (light arrows) and you may good T5–6 disk extrusion (black arrowhead) that displaces the latest dura (light arrowhead) posteriorly. Mention partial calcification of one’s disk (black arrowhead) additionally the presence from an excellent subarachnoid clot (black colored arrow). C, Lateral view of the brand new thoracic back gotten while in the electronic substraction myelography on diligent throughout the vulnerable position. Notice cephalad extension of evaluate in the thecal sac (black colored arrowhead), focal extravasation of examine courtesy a great ventral dural split within T5–six (light arrow) towards epidural range (black arrow), and you will onward cephalad expansion about epidural fluid range. The newest asterisk implies improved attenuation of your own contrast from the less level of the brand new epidural area compared to the subarachnoid place. In this patient, a ventral dural tear from the T5–6 are surgically fixed, and you will a beneficial thoracic spine MR imaging did 90 days afterwards demonstrated solution of the ventral epidural liquid collection. thirty six Adjusted having consent away from J.M. Hoxworth. thirty six