Ajay Agarwal MD, Presenter: Nothing to Disclose

To demonstrate characteristic imaging findings seen in ventral cord heniation.

Etiopathogenesis:The etiopathogenesis of idiopathic spinal cord herniation is not firmly established, but the presence of a dural defect is considered a sine qua non for the development of the condition. Clinical presentation: Clinical findings are nonspecific and patients usually present with slowly progressive Brown-Sequard syndrome or paraplegia. Imaging featuree: We will demonstrate MR imaging findings in four patients with surgically confirmed spinal cord herniation. The thoracic spine is commonly involved between the T4 and T7 vertebrae. Characteristic MRI findings include dural defect through which ventral displacement of the thoracic spinal cord occurs with enlargement of the dorsal subarachnoid space. “Nuclear trail” sign" is also described as the characteristic sign on CT. Differentials:It is important to exclude a dorsally located cystic lesion (eg, an intradural arachnoid cyst), which may mimic a cord herniation. Conclusion:Idiopathic spinal cord herniation is rare but is an increasingly recognized cause of progressive and potentially curable thoracic myelopathy. An early and correct diagnosis allows prompt treatment, which may reverse any neurologic deficits.      

http://abstract.rsna.org/uploads/2014/14000865/14000865_qur2.pdf

Agarwal, A, Imaging of Idiopathic Spinal Cord Herniation.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14000865.html