Age: 51
Sex: Male
Indication: Pedestrian hit by car, right C3 and left C7-T1 transverse process fractures on prior CT
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Case #18
Findings
- Known right C3 and left C7-T1 transverse process fractures are not well demonstrated on this study
- No evidence of traumatic malalignment or ligamentous injury
- T2/STIR hyperintense intramedullary lesion spanning C7-T4 with associated fusiform cord expansion resulting in effacement of CSF in the thecal sac at these levels
- Possible small areas of internal cystic change at the level of T1-T2
- Reversal of the usual cervical lordosis centered at C4-C5
- Mild anterolisthesis at C7-T1
- Mild T2/STIR signal hyperintensity in the endplates about the T2-T3 disc, favored degenerative in etiology
- Multilevel degenerative changes with posterior disc-osteophyte complexes, facet hypertrophy, and uncovertebral spurring contributing to mild to moderate spinal canal stenosis at C5-C6 and C6-C7 and varying degrees of multilevel neural foraminal stenosis, moderate in severity on the left at C3-C4, on the right at C5-C6, and bilaterally at C6-C7
Diagnosis
- Spinal ependymoma
Sample Report
Known right C3 and left C7-T1 transverse process fractures are not well demonstrated on this study. No evidence of traumatic malalignment or ligamentous injury.
T2/STIR hyperintense intramedullary lesion spanning C7-T4 with associated fusiform cord expansion resulting in effacement of CSF in the thecal sac at these levels. Possible small areas of internal cystic change at the level of T1-T2. This lesion is primarily concerning for a neoplasm, with ependymoma and astrocytoma being the primary differential considerations. Recommend neurosurgical evaluation and consideration of a repeat MRI with and without contrast for further evaluation.
Reversal of the usual cervical lordosis centered at C4-C5. Mild anterolisthesis at C7-T1. Mild endplate edema about the T2-T3 disc. These findings are favored degenerative in etiology.
Multilevel degenerative changes with posterior disc-osteophyte complexes, facet hypertrophy, and uncovertebral spurring contributing to mild to moderate spinal canal stenosis at C5-C6 and C6-C7 and varying degrees of multilevel neural foraminal stenosis, moderate in severity on the left at C3-C4, on the right at C5-C6, and bilaterally at C6-C7.
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