Type:
Educational Exhibit
Keywords:
Neuro, CNS, MR, Contrast agent-intravenous, Education and training, Not applicable, Performed at one institution
Authors:
M. Akyuz, E. CINDIL, A. Y. ONER, H. K. Kilic, E. T. Tali; Ankara/TR
DOI:
10.26044/ecr2020/C-15172
Findings and procedure details
Non - Traumatic Spinal Emergencies:
Astrocytoma, Ependimoma, Hemangioblastoma, Schwannoma, Menenengioma, Osteosarcoma, Metastasis* (Fig. 1)...
*Metastasis:
- Hematogenous Metastasis:
Most commonly due to lung cancer
Thoracic > Cervical > Lumbal
- Drom Metastasis:
Most commonly due to medulloblastoma
Lumbal > Thoracic
- Symptoms: Radicular pain, paresthesias, muscle weakness, incontinence...
- 2 - Infectious / Inflammatory / Autoimmune / Demyelinating
Multiple Sclerosis, Neuromyelitis Optica, Neurosarcoidosis, Spondylodiscitis, SLE, Idiopathic transverse myelitis, Behcet's Disease* (Fig. 2)...
Behcet's Disease:
- Mediterranean region (Turkey - highest incidence), middle east
- Systemic Vasculitis
- Brain > Spinal Cord
AVF, Cavernoma, Hemangioma, Arteriovenous Malformation* (Fig. 3), Spinal Cord Infarct** (Fig. 4)...
*Arteriovenous Malformation
- Treatable
- Feeding artery, nidus, draining vein
- Diffuse central spinal cord edema
- Hemorrhage, gliosis
**Spinal Cord Infarct:
- Endovascular and interventional radiology procedures related to aorta, atherosclerosis, thromboembolism, systemic hypotension, vasculitis, aortic dissection
Acute Compression Fractures, Acute Disc Herniation* (Fig. 5)...
*Acute Disc Herniation:
- The most common cause of non-traumatic spinal emergencies
- Annular contrast enhancement and increased T2 signal intensity within the disc indicate an acute event
- Increased T1 signal within the disc indicates hemorrhage
- 5 - Toxic / Metabolic / Paraneoplastic
Paraneoplastic Syndromes, Subacute Combined Degeneration, Drug-Related Myelitis* (Fig. 6)...
*Drug-Related Myelitis:
- Nonspecific imaging findings
- Subacute, progressive
- Methotrexate, amiodarone, amphotericin...
- Clinical information is of prime importance
Postoperative complications (epidural hemorrhage, spondylodiscitis, abscess(Fig. 7), etc.)
*Spondylodiscitis, Abscess:
- Osteomyelitis + discitis + spondylitis
- Hematogenous, direct inoculation, local spread
- S. Aureus
- Abscess indicates bad prognosis