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Age: 55

Sex: Female

Indication: Concern for spinal stenosis

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Case #19


Findings

  • Ventral positioning of the spinal cord in the thecal sac in the mid thoracic spine with focal concave deformity along the dorsal aspect of the cord just below the level of T5-T6
  • No cord signal abnormality
  • No definite ventral dural defect
  • No discrete collection within the thecal sac, with prominent CSF pulsation artifact dorsally
  • Exaggerated thoracic kyphosis
  • Small multilevel disc herniations including a superiorly dissecting disc extrusion at T6-T7 without significant spinal canal stenosis
  • No advanced neural foraminal stenosis
  • Normal marrow signal


Diagnosis

  • Dorsal arachnoid web

Sample Report

Ventral positioning of the spinal cord in the thecal sac in the mid thoracic spine with focal concave deformity along the dorsal aspect of the cord just below the level of T5-T6, which raises concern for a dorsal arachnoid web, dorsal arachnoid cyst, or ventral cord herniation. Arachnoid cyst is favored less likely given CSF pulsation artifact along the dorsal aspect of the cord at this level. Consider CT myelogram for further evaluation.

Multilevel mild degenerative changes without advanced spinal canal or neural foraminal stenosis.


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Images

Ventral displacement of the thoracic spinal cord with dorsal cord indentation (red arrow), which in this case is concerning for the presence of an arachnoid web.



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