Interactive Transcript
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I wanted to demonstrate this most
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dramatic case that I have seen,
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that is in the differential diagnosis
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of an arachnoid cyst.
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We have the post myelogram CT on either side of
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the T2-weighted scan of the spinal cord.
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On this T2-weighted scan,
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you see that the cord is deviated dramatically anteriorly.
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In fact, the cord is leading to scalloping
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of the mid thoracic vertebrae,
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and there is dilatation of the subarachnoid
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space posteriorly.
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This is another example of probably the most
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dramatic case of transdural herniation of
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the spinal cord that I've seen.
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Here on the sagittal reconstructions
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of the post myelogram CT,
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we have the spinal cord coming up
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here from the lumbar region.
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And then you have the spinal cord being
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deviated and causing scalloping of vertebrae.
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And you have the subarachnoid space
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dilatation, so this cord has herniated through
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the dura, transdural spinal cord herniation
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and subarachnoid space
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dilatation. In this example, was secondary to trauma.
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This is a very unusual complication and
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oftentimes, the trauma is subclinical.
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In other words,
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the patient has had a remote history
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of a motor vehicle collision.
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And we find the patient with a thoracic myelopathy
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months to years later demonstrating this phenomenon.
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So again,
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transdural herniation of the spinal cord.
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The most dramatic example that I've seen.
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