and John P. Deveikis2 (1) Department of Surgery, Division of Neurosurgery, and Departments of Radiology and Neurology, University of Alabama, Birmingham, AL, USA (2) Bayfront Medical Center, St. Petersburg, FL, USA …
and John P. Deveikis2 (1) Department of Surgery, Division of Neurosurgery, and Departments of Radiology and Neurology, University of Alabama, Birmingham, AL, USA (2) Bayfront Medical Center, St. Petersburg, FL, USA …
and John P. Deveikis2 (1) Department of Surgery, Division of Neurosurgery, and Departments of Radiology and Neurology, University of Alabama, Birmingham, AL, USA (2) Bayfront Medical Center, St. Petersburg, FL, USA …
Not osteonecrosis (Kümmell disease) Imaging • Well-defined, geographic signal abnormality, which tends to involve anterior 1/3 to 1/2 of vertebral body • T2WI shows increased signal in multiple bodies, with abrupt transition…
However, matrix may range from purely lytic to purely sclerotic lesion • Narrow zone of transition ± sclerotic margin • Low to intermediate signal intensity on T1WI, heterogeneous on T2WI, STIR, variable…
Fascicles indistinct • Perineural enhancement • ± mass compressing nerve • Denervation changes in muscles distal to entrapment Top Differential Diagnoses • Cervical radiculopathy • Tenosynovitis • Peripheral nerve sheath tumor • Thoracic outlet syndrome Pathology • Overuse…
Motor or sensory deficits, ataxia, diplopia, dysarthria, dysmetria, vertigo, visual field deficit, cranial nerve dysfunction, syncope • Treatment Brace to restrict head motion, surgical fusion to prevent atlantoaxial rotation, vertebral artery…
Antibodies against intracellular antigens Older individuals, resistant to treatment Mediated by T-cell mechanisms • Most common with lung and breast cancer • Most common antibodies causing myelopathy Amphiphysin-IgG Collapsin response-mediator protein-5 (CRMP-5)…
Slightly higher on T2WI, STIR than on T1WI Abnormalities may be diffuse or patchy Signal intensity does not change between in- and out-phase imaging Minimal or no enhancement with gadolinium…
Pedicolaminar fracture-separation Imaging • Asymmetric hyperextension pattern of injury to posterior column • Below C2; most common at C6 and C7 • Fracture of articular facet Associated with radiculopathy • Fracture of articular pillar…
