Demographics:
33 years old, Male
Indication:
Back pain, known cryptococcal meningitis
Findings
- Clumping and dorsal displacement of nerve roots of the cauda equina with faint associated enhancement
- Transverse enhancing membrane just below the L4-L5 level, below which the cauda equina nerve roots are more evenly distributed throughout the thecal sac
- No nodular or mass-like enhancement
- No epidural collection
- Normal marrow signal
- Trace retrolisthesis at L5-S1
- Multilevel small Schmorl's nodes
- Small central disc bulge at L5-S1 without significant spinal canal or neural foraminal stenosis
Diagnosis
Arachnoiditis
Sample Report
Findings are concerning for arachnoiditis with clumping and eccentric displacement of nerve roots of the cauda equina. A transverse enhancing membrane just below the L4-L5 level likely represents postinfectious scarring/adhesion.
No discrete extraaxial collection.
Discussion
References