Demographics:
51 years old, Male
Indication:
Bilateral leg weakness
Findings
- Central cord T2/STIR signal hyperintensity from the levels of T5-T10 with associated mild cord expansion and possible mild enhancement
- Prominent intrathecal vessels at the level of T9-T10
- Central disc herniation at T2-T3 contributes to mild bilateral neural foraminal stenosis without significant spinal canal stenosis
- Central disc herniation at T10-T11 in combination with facet hypertrophy contributes to moderate right and mild left neural foraminal stenosis without significant spinal canal stenosis
- Bilateral facet hypertrophy at T11-T12 and T12-L1 contributes to moderate right and mild left neural foraminal stenosis at both levels
- Conus terminates at L1, in normal position
- Normal marrow signal
- Normal alignment
Diagnosis
Spinal dural arteriovenous fistula
Sample Report
Central cord edema spanning T5-T10 with associated mild cord expansion and possible mild enhancement, which in combination with the finding of serpiginous vessels in the thecal sac at the level of T9-T10 raises concern for a dural AV fistula. Additional diagnostic considerations include cord infarct and transverse myelitis. Recommend neurosurgical evaluation and consideration of catheter angiography.
Discussion