ABSTRACT
PURPOSE: To determine level of the thecal sac ending in unaffected individuals of young age-group and in patients with cerebrospinal fluid (CSF) seeding tumor using Magnetic Resonance Imaging (MRI). MATERIAL AND METHOD: MRI of the lumbosacral spine of 253 cases (age range 1-40 years) had been reviewed. Of these, 20 cases were known having CSF seeding tumors. Two hundred and thirty-three cases of unaffected individuals were used as control group. Sagittal MR images were used to determine the level of thecal sac ending by referencing on the corresponding vertebral body and intervertebral disc. RESULTS: The range of the thecal sac ending level in unaffected population varied from the lower one-third of L5 to the middle one-third of S3. About 97% of cases, the distal end of thecal sac terminated at the S2-3 intervertebral disc space or higher. In patients with CSF seeding tumor, the range of thecal sac ending was from the middle one-third of L5 to the S2-3 intervertebral disc space. There was no statistically significant difference of thecal ending level between unaffected group and patients with CSF seeding tumors (p=0.19). CONCLUSION: Placing inferior border of radiation field at the middle one-third of S3 vertebra would help to cover the entire subarachnoid space in all cases. Without MR machine, this study may be used as a general guideline for placing the inferior border for spinal irradiation.
Subject(s)
Adolescent , Adult , Case-Control Studies , Child , Child, Preschool , Female , Humans , Infant , Lumbosacral Region/pathology , Magnetic Resonance Imaging , Male , Spinal Cord Neoplasms/pathology , Subarachnoid Space/pathologyABSTRACT
A case of pineal germinaoma spreading along the basal subarachnoid space, clinically and macroscopically at autopsy, resembling tuberculous basal arachnoiditis is reported. Need to carry out CSF cytology of even hemorrhagic CSF is stressed, to diagnose the condition.
Subject(s)
Adult , Brain Neoplasms/diagnosis , Diagnosis, Differential , Female , Germinoma/diagnosis , Humans , Neoplasm Invasiveness , Pineal Gland , Subarachnoid Space/pathology , Tuberculosis, Meningeal/diagnosisABSTRACT
Suprasellar dermoid cysts are uncommon intracranial lesions. CT and MRI findings in a rare case of asymptomatic rupture of suprasellar dermoid cyst with subarachnoid dissemination is described.
Subject(s)
Brain Neoplasms/diagnosis , Dermoid Cyst/diagnosis , Female , Humans , Magnetic Resonance Imaging , Middle Aged , Rupture, Spontaneous , Sella Turcica , Subarachnoid Space/pathologyABSTRACT
Se describe un nuevo caso de pubertad precoz verdadera isosexual secundaria a la presencia de un quiste subaracnoideo en una niña de 16 meses de edad. El motivo de la consulta fue haber presentado dos episodios de sangrado endometrial. Los resultados endocrinológicos demostraron actividad del eje hipotálamo-hipófisis-ovario, mientras que la arteriografía y la tomografía axial computada de cráneo evidenciaron la presencia de un quiste subaracnoideo de gran tamaño. La resección quirúrgica de la mayor parte del quiste, con la colocación de una válvula de derivación, no fue suficiente para suprimir la actividad hormonal, por lo que fue necesario instituir tratamiento supresivo a base de acetato de medroxiprogesterona con lo que se ha logrado detener el proceso puberal