Dave's Neuroradiology Spine

Front 1

multiple sclerosis of the spinal cord

Back 1

longitudinal flame shaped lesions

dorsolateral location

cervical>thoracic

use FSE, not gad for sensitivity

active lesions may enhance

tumefactive ms vs tumor

thing slice sagittal flair of the brain

Front 2

inflammatory diseases of the spinal cord

Back 2

adem/ms

lupus myelitis

viral myelitis-affect gray matter

ischemia-affect gray matter

sarcoidosis-pial disease

radiation-bright signal in the cord, with bright signal in the vert. bodies

guillen-barre-enhancement of the nerve roots

Front 3

lupus related myelitis

Back 3

prolonged T1 or T2 signal (100%)

75% cord enlargement, 50% of which show enhancement->resolve if steroid responsive

eventual myelomalacia

Front 4

early staph aureus vertebral osteomyelitis

Back 4

may appear as pure vertebral osteo not yet involving the disc

eventually affects disc

thickening and enhancement of the paraspinous ligaments and muscles all more consistent with infection than neoplasm

extensive thickened and enhancement anterior longitudinal ligament usually indicates infection...lymphoma is the only mimic but is disc sparing

Front 5

TB in spine

Back 5

TB, consider if paraspinous involvement is present with cold abscesses

pachymeningitis

Front 6

spinal cord-vacuolar myelopathy in AIDS

Back 6

presentation similar to vit b12 deficiency

30% incidence at autopsy

flamed shaped high t2 intensity in spinal cord

intrameylin and periaxonal vacuolization in the cord WM, particularly posterior and lateral columns

Front 7

differentiating spinal cord tumors based on location

Back 7

intradural/intramedullary
cord widened in all views
csf space thinned on all sides

intradural/extramedullary
"marble on carpet"
cord widened in 1-2 views
csf space thinned on one side, maybe widened on other

extradural
marble under the carpet
dural and thecal sace displaced together
cord maybe widened in one plane
csf space thinned on all sides

Front 8

adult spinal neoplasms frequency

Back 8

neural origin (schwannoma) 29%

meningiomas 25%

intramed ie astrocytoma 23%

other ie sarcomas, vascular tumors, chordomas, intraspinal mets 23%

Front 9

children spinal neoplasms frequency

Back 9

developmental 38%
teratomas/dermoids
sydringohydromyelia
lipomas
neurenteric cysts
intraspinal meningoceles

primary neural neoplasms 30%

csf mets 10%

other 22%

Front 10

tumors of the conus

Back 10

myxopapillary ependymoma
scwhwannoma
meningioma
drop mets

Front 11

syringohydromyelia

Back 11

any cyst of cord

hydromyelia-dilatation of central canal (chiari 1 or foramen magnum mass)

syringomyelia-glia-lined cyst; assoc with tumor; arachnoiditis

tumor cyst

Front 12

causes of scoliosis

Back 12

look up

Front 13

chiari 1

Back 13

cerebellar tonsils ≥ 5 mm below foramen magnum, ± syringohydromyelia

Front 14

chiari 2

Back 14

small posterior fossa

"cascade" or "waterfall" of cerebellum/brainstem downwards

medulla "heaps up" over cord tethered by dentate ligaments ⇒cervicomedullary "kink

beaked tectum

low-lying torcular herophilli

associated abnormalities
spine
open dysraphism (mmc) ~ 100% (lumbar > > cervical)
posterior arch C1 anomalies (66%)
hydrosyringomyelia (20-90%)
diastematomyelia (5%)
klippel-Feil syndrome
cervical myelocystocele

brain/skull
corpus callosum (CC) dysgenesis (90%)
aqueductal stenosis

other-rhombencephalosynapsis, gray matter malformations, absent septum pellucidum, fused forniceal columns

lacunar skull
(Lückenschädel)

Front 15

chiari 3

Back 15

chiari II malformation + high to mid-cervical cephalocele containing cerebellum

ccJ or high cervical cephalocele
meninges, cerebellum ± brainstem
cisterns, 4th ventricle, dural sinuses (50%)
± hydrocephalus
± Intracranial Chiari II malformation