0:01

Here is another patient who has an Arnold Chiari

0:03

malformation that was previously repaired.

0:07

However, the patient represented with possible retethering

0:11

of the spinal cord. On the T1-weighted scan,

0:14

we see the spinal dysraphism with fluid, as well as tissue

0:18

extending into the pouch outside the thecal sac.

0:23

This tissue that is outside the thecal sac does not

0:26

look like neural elements, and in point of fact,

0:28

this was all granulation tissue.

0:30

However, you note that the spinal cord was still

0:33

relatively low in its location,

0:35

terminating at approximately L3 and then tethered

0:39

along the posterior aspect of the spinal canal.

0:43

On the axial scans,

0:44

we get the better sense of the meningocele, as well as

0:49

this irregular tissue that has hemorrhagic products.

0:52

But you notice that it's not an open abnormality,

0:55

the way it would be in a congenital myelomeningocele.

0:59

So this patient has granulation tissue,

1:03

myelomeningocele, as well as tethering of the spinal cord

1:08

in a patient who had been previously

1:10

had surgery for congenital arnold chiari malformation

1:14

and myelomeningocele.

Recurrent Myelomeningocele and Cord Tethering After Repair

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