Spinal Artery Aneurysm

Oct 5, 2016 by in NEUROLOGICAL IMAGING Comments Off on Spinal Artery Aneurysm

 Tend to be fusiform in shape, without a defined neck (as seen commonly with intracranial aneurysms)  Often unrelated to arterial branching sites Clinical Issues • Presenting symptoms include back pain, headache,…

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Epidural Lipomatosis

Oct 5, 2016 by in NEUROLOGICAL IMAGING Comments Off on Epidural Lipomatosis

 T6-T8, dorsal to spinal cord  Epidural fat ≥ 7 mm thick • Lumbar spine: 39-42%  L4-L5, surrounding thecal sac • Y-shaped configuration to lumbar thecal sac on axial imaging • Mass effect on…

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Renal Osteodystrophy

Oct 5, 2016 by in NEUROLOGICAL IMAGING Comments Off on Renal Osteodystrophy

 Blurred, coarse bone trabeculae • Changes of hyperparathyroidism (HPT)  Prominent primary trabeculae  Resorption of secondary trabeculae  Cortical thinning  Erosions at entheses, endplates, sacroiliac (SI) joints  Brown tumors: Lytic lesion, no matrix,…

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Traumatic Arteriovenous Fistula

Oct 5, 2016 by in NEUROLOGICAL IMAGING Comments Off on Traumatic Arteriovenous Fistula

 DSA demonstration of AVF nidus with enlarged draining veins  Unlike spontaneous DAVF (sDAVF), often no cord enlargement/hyperintensity from congestive myelopathy • Angiographic protocol for evaluation of suspected cervical tDAVF includes selective…

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Pathways of Spread

Oct 5, 2016 by in NEUROLOGICAL IMAGING Comments Off on Pathways of Spread

(Left) Sagittal graphic shows lumbar disc space infection with vertebral body osteomyelitis with endplate destruction and marrow edema. There are ventral and dorsal abscess collections. (Right) Sagittal T1WI C+ FS…

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Grisel Syndrome

Oct 5, 2016 by in NEUROLOGICAL IMAGING Comments Off on Grisel Syndrome

 Anteriorly rotated side wider and closer to odontoid  Opposite side smaller and farther from odontoid • Lateral view: ± widened atlantodental interval • Dynamic CT: Should include occiput C1-C2  Initial scan: Maintain…

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Hirayama Disease

Oct 5, 2016 by in NEUROLOGICAL IMAGING Comments Off on Hirayama Disease

 2nd to 3rd decades • Avoidance of neck flexion can stop progression • Selected patients treated with posterior decompression with duraplasty Diagnostic Checklist • Asymmetric atrophy of lower cervical cord on routine MR…

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Complex Chiari

Oct 5, 2016 by in NEUROLOGICAL IMAGING Comments Off on Complex Chiari

 “Bump” thought to represent aberrant clava, used as marker for cervicomedullary junction  Abnormal tonsillar “pistoning” motion, reduced CSF flow around foramen magnum and cerebellar tonsils • ± syringohydromyelia, ventral cervicomedullary compression…

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Osteopetrosis

Oct 5, 2016 by in NEUROLOGICAL IMAGING Comments Off on Osteopetrosis

 Infantile presentation (“congenita”)  Intermediate presentation  Adult presentation (“tarda”) • All feature abnormal osteoclastic activity Clinical Issues • Fractures, pain, neurologic symptoms • Growth disturbance in infantile forms Diagnostic Checklist • Osteopetrosis in differential diagnosis…

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Anterior Lumbar Radiculopathy

Oct 5, 2016 by in NEUROLOGICAL IMAGING Comments Off on Anterior Lumbar Radiculopathy

(Left) Sagittal T1WI MR in a leukemia patient with leg weakness following intrathecal chemotherapy shows normal appearance of the conus and cauda equina. (Right) Sagittal T1WI C+ MR in a…

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