ABSTRACT
Arachnoid cysts are a common incidental finding on routine brain imaging and, for the most part, their presence is uneventful. Occasionally they may be associated with haemorrhage into the subdural compartment. Rarer still is simple rupture of the contents of the arachnoid cyst into the extra-axial space. MRI can help distinguish between these two rare occurrences--an important distinction to make as this may assist in directing the treating clinician toward the most appropriate management plan.
Subject(s)
Arachnoid Cysts/complications , Cranial Fossa, Middle , Subdural Effusion/etiology , Arachnoid Cysts/diagnosis , Child , Humans , Magnetic Resonance Imaging/methods , Male , Rupture, Spontaneous/diagnosis , Subdural Effusion/diagnosis , Tomography, X-Ray Computed/methodsABSTRACT
Epidural abscess of the cervical spine is an uncommon disorder. The presentation is often non-specific and the diagnosis unsuspected. Magnetic resonance (MR) imaging is now considered the imaging investigation of choice. We report six patients with cervical epidural abscess diagnosed on MR imaging. The MR imaging showed the abscess to have a variable appearance and enhancement characteristics. Follow-up MR examinations confirmed resolution of the abscess and, in five cases, allowed conservative management.
Subject(s)
Abscess/pathology , Cervical Vertebrae/pathology , Spinal Diseases/pathology , Staphylococcal Infections/pathology , Tuberculosis, Spinal/pathology , Adult , Female , Follow-Up Studies , Humans , Male , Middle Aged , Retrospective Studies , Spinal Cord Compression/pathologyABSTRACT
This study investigated whether paraspinal muscle wasting occurs in association with chronic low back pain (LBP). Cross-sectional areas (CSA) of spinal and paraspinal structures were measured radiographically, at the level of L4, in 43 patients with recent and 44 with chronic LBP. Crude anthropometry demonstrated no differences between the groups with regard to L4 and paraspinal and psoas muscle CSAs, but inter-individual differences were large. Since body weight correlated significantly with L4 CSA this dimension was used as an 'internal standard' and further inter-individual comparisons were made using paraspinal: L4 and psoas: L4 (i.e. muscle to bone) CSA ratios. Muscle assessments made in this 'relative' fashion revealed significant reductions in paraspinal and psoas dimensions in patients with chronic compared to recent onset LBP. These changes could cause paraspinal and psoas muscle weakness and thereby predispose to spinal instability and progressive dysfunction.
Subject(s)
Back Pain/complications , Muscular Atrophy, Spinal/diagnostic imaging , Adult , Chronic Disease , Female , Humans , Lumbar Vertebrae , Male , Middle Aged , Muscular Atrophy, Spinal/complications , Tomography, X-Ray ComputedABSTRACT
Eleven patients have been examined by whole body CT employing the EMI CT 5000 following lumbar injection of 10 ml of metrizamide (Amipaque) 170 mg I/ml. The distribution, flow and dilution of the contrast medium have been investigated. The results suggest that whilst metrizamide is necessary in the spinal canal to demonstrate the neural axis and pathologic processes affecting it, it appears to enter the extracellular space of the spinal cord during the first hour and achieves an equilibrium in the subarachnoid space and spinal cord from 3 to 6 hours. The medium may concentrate in a second compartment, possibly intracellular, from 3 to 6 hours. The effect of spectral filtering by metrizamide on the attenuation values of the spinal cord has been modelled and shown not to be significant at the anticipated dilution of the medium in the cerebrospinal fluid space and the spinal canal.
