Training Collections
Library Memberships
Black Friday Save 30%On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Black Friday Save 30%Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Black Friday Save 40%Unlock access to our full Course Library and all self-paced Fellowships.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Dr. Resnick's MSK Conference
BLACK FRIDAY SAVE 30%Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
Training Collections
Library Memberships
Black Friday Save 30%On-demand course library with video lectures, expert case reviews, and more
Fellowship Certificate™ Programs
Black Friday Save 30%Practice-focused training programs designed to help you gain experience in a specific subspecialty area.
Ultimate Learning Pass
Black Friday Save 40%Unlock access to our full Course Library and all self-paced Fellowships.
Noon Conference (Free)
Get access to free live lectures, every week, from top radiologists.
Case of the Week (Free)
Get a free weekly case delivered right to your inbox.
Dr. Resnick's MSK Conference
BLACK FRIDAY SAVE 30%Learn directly from the MSK Master himself.
Lower Extremities MRI Conference
Musculoskeletal Imaging
Emergency Imaging
PET Imaging
Pediatric Imaging
For Training Programs
Supplement your training program with case-based learning for residents, registrars, fellows, and more.
For Private Practices
Upskill in high growth, advanced imaging areas.
Emergency Call Prep
Prepare trainees to be on call for the emergency department with this specialized training series.
Lesson
Intradural Intramedullary Spinal Lesions Pre-Course Activities
1 topic, 4 min.
Lesson
Introduction to Spinal Imaging - Intradural Intramedullary Lesions
6 topics, 21 min.
Lesson
Neoplasms
13 topics, 42 min.
Neoplasms of the Intradural Intramedullary Space
1 m.Ependymoma Associated with NF2
4 m.Ependymoma
2 m.Myxopapillary Ependymoma
2 m.Cervical Spinal Cord Astrocytoma
4 m.Cervical Spinal Cord Glioblastoma
4 m.Hemangioblastoma of the Spinal Cord
4 m.Hemangioblastoma at the Conus Medullaris
4 m.Neurologic Manifestations of Von Hippel Lindau Disease
4 m.Additional Spinal Canal Manifestations of VHL
3 m.Cervical Spinal Cord Ganglioglioma
3 m.Rare Case of a Spinal Cord Lipoma
3 m.Summary of Intradural Intramedullary Neoplasms
12 m.Lesson
Demyelinating
4 topics, 17 min.
Lesson
Infection/Inflammation
7 topics, 33 min.
Acute Disseminated Encephalomyelitis of the Spinal Cord
4 m.Summary of Acute Disseminated Encephalomyelitis
2 m.Chiari 1 with Syringohydromyelia
5 m.Summary of congenital lesions of the spinal cord
11 m.Spinal Cord Infectious and Inflammatory Disorders
6 m.Cysticercosis of the Spinal Cord
4 m.Sarcoidosis of the Spinal Cord
5 m.Lesson
Trauma and Vascular Disorders
9 topics, 39 min.
Hemorrhage within the Spinal Cord
4 m.Hematomyelia and Spinal Cord Cavernomas
7 m.Cavernoma of the Spinal Cord
3 m.Dural Arteriovenous Fistula
5 m.Type II Dural AVF and its Potential Consequences
5 m.Intramedullary AVM in the setting of Type II Dural AVF
2 m.Assessing Vascular Malformations on MRA
5 m.Common Causes and Imaging of Spinal Cord Ischemia/Infarction
8 m.Spinal Cord Infarct
5 m.Lesson
Idiopathic/Acquired
4 topics, 16 min.
0:00
When considering intradural intramedullary
0:03
lesions in children,
0:04
we should consider the possibility of ADEM.
0:07
Remember that this was originally described as a
0:11
monophasic disease, but we now know that it,
0:13
too, may be polyphasic.
0:15
It occurs classically two to four weeks after
0:17
viral illnesses, most commonly,
0:20
immunizations, much less commonly.
0:23
It is a delayed type hypersensitivity type IV
0:26
reaction to the myelin basic protein.
0:29
So it's an autoimmune disorder,
0:31
and you may have both brain and spine lesions.
0:33
There is a hemorrhagic aggressive form that only
0:36
occurs in the brain, not in the spinal cord.
0:39
Where does ADEM occur? As you can see,
0:42
predominantly in the brain.
0:45
However, the cord lesions occur in 50% of patients who
0:51
are children and 10% of adult lesions, so
0:55
much more likely to occur in the brain.
0:57
But you may see manifestations in the cord
1:00
in children after viral illnesses.
1:04
The typical ADEM appearance in the brain shows
1:08
both white matter confluent lesions, as well as
1:11
deep gray matter lesions, distinguishing
1:14
it from multiple sclerosis.
1:17
And these lesions may or may not
1:19
show contrast enhancement.
1:22
As I mentioned, sometimes you will have multiphasic
1:25
disseminated encephalomyelitis,
1:28
and this may be a precursor to the development
1:33
as an adult of multiple sclerosis.
Summary of Acute Disseminated Encephalomyelitis
HIDEInteractive Transcript
0:00
When considering intradural intramedullary
0:03
lesions in children,
0:04
we should consider the possibility of ADEM.
0:07
Remember that this was originally described as a
0:11
monophasic disease, but we now know that it,
0:13
too, may be polyphasic.
0:15
It occurs classically two to four weeks after
0:17
viral illnesses, most commonly,
0:20
immunizations, much less commonly.
0:23
It is a delayed type hypersensitivity type IV
0:26
reaction to the myelin basic protein.
0:29
So it's an autoimmune disorder,
0:31
and you may have both brain and spine lesions.
0:33
There is a hemorrhagic aggressive form that only
0:36
occurs in the brain, not in the spinal cord.
0:39
Where does ADEM occur? As you can see,
0:42
predominantly in the brain.
0:45
However, the cord lesions occur in 50% of patients who
0:51
are children and 10% of adult lesions, so
0:55
much more likely to occur in the brain.
0:57
But you may see manifestations in the cord
1:00
in children after viral illnesses.
1:04
The typical ADEM appearance in the brain shows
1:08
both white matter confluent lesions, as well as
1:11
deep gray matter lesions, distinguishing
1:14
it from multiple sclerosis.
1:17
And these lesions may or may not
1:19
show contrast enhancement.
1:22
As I mentioned, sometimes you will have multiphasic
1:25
disseminated encephalomyelitis,
1:28
and this may be a precursor to the development
1:33
as an adult of multiple sclerosis.
Report
Description
Faculty
David M Yousem, MD, MBA
Professor of Radiology, Vice Chairman and Associate Dean
Johns Hopkins University
Tags
Spine
Pediatrics
Non-infectious Inflammatory
Neuroradiology
Musculoskeletal (MSK)
MRI
Idiopathic
Brain
Acquired/Developmental
© 2024 Medality. All Rights Reserved.