Spinal trauma and preexisting spinal canal stenosis In a

stenotic spinal canal even minor trauma may induce major cord damage. This can be due to sudden compression of the whole myelon (Fig. 11.51a) or the focal compression of the anterior spinal artery (Fig. 11.51b).

I Intervertebral Disk Prolapse

I The Case of Ann Ray

I Intervertebral Disk Prolapse

Thecal Sac Compression Pain

Fig. 11.48 The CT section obtained parallel to the vertebral end plates shows severe compression of the thecal sac by soft tissue isodense to intervertebral disk substance. This is a massively prolapsed disk.

Fig. 11.47 Take a look at these representative MR images of Ann Ray. Do you have a suspicion what this could be?

Fig. 11.48 The CT section obtained parallel to the vertebral end plates shows severe compression of the thecal sac by soft tissue isodense to intervertebral disk substance. This is a massively prolapsed disk.

I Extradural Spinal Tumor a Plasmacytoma b Pancoast tumor a Plasmacytoma b Pancoast tumor

Where Does The Thecal Sac End

Fig. 11.49a The spinal cord on this sagittal T1-weighted contrast-enhanced MR image is compressed considerably by the soft tissue component of a plasmacytoma. Plasmacytoma frequently causes destruction of the cancellous and cortical bone. b The coronar-yT1-weighted MRI section after contrast administration reveals a Pancoast tumor, a mass originating in the pulmonary apex that may invade the spinal canal through the neuroforamina and subsequently may cause spinal cord compression. Cranially it involves the brachial plexus and can present with Horner syndrome.

I Intradural Spinal Tumor a Spinal meningioma a Spinal meningioma

Neuroforamina

Fig. 11.50a This spinal meningioma is even detectable on the lumbar radiograph (left) because its slow growth has forced the pedicles apart (arrows). The axial T1-weighted MR image obtained after contrast administration (right) displays the avidly enhancing tumor, which has expanded the spinal canal. b A number of smaller and one larger metastases of an esophageal carcinoma are seen here studding the spinal cord. The primary tumor has directly invaded the spinal canal at a higher level. c After contrast administration, the intra-axial spinal metastasis of a breast carcinoma is very well appreciated.

b Thecal metastatic disease c Metastatic disease involving the spinal cord

Lower Ray After Bowel ResectionLower Ray After Bowel Resection
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