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Congress: ECR25
Poster Number: C-24818
Type: Poster: EPOS Radiologist (educational)
Authorblock: P. K. Devatha, N. L. N. Moorthy; Hyderabad/IN
Disclosures:
Pranav Kumar Devatha: Nothing to disclose
N Lakshmi N Moorthy: Nothing to disclose
Keywords: CNS, Conventional radiography, CT, Contrast agent-intravenous, Acute, Neoplasia
Learning objectives Acute myelopathy in a nontraumatic setting is a medical emergency requiring prompt diagnosis and intervention to prevent irreversible neurologic damage. Spinal MRI is the primary imaging modality used to assess suspected cord compression. Emergency department radiologists must be adept at differentiating compressive from noncompressive causes of myelopathy, as the management strategies differ significantly. This paper provides a concise overview of the MRI findings and differential diagnoses for nontraumatic spinal cord compression, focusing on a compartmental approach to localize lesions and...
Read more Background This review is based on a comprehensive analysis of the literature and clinical experience in the evaluation of traumatic and nontraumatic spinal cord compression. We included 40 patients with low back ache , with a focus on MRI findings in acute myelopathy. Key imaging sequences, including T1-weighted, T2-weighted, short tau inversion recovery (STIR), and contrast-enhanced MRI, were evaluated to identify characteristic features of compressive and noncompressive myelopathy.The compartmental approach to spinal MRI interpretation was emphasized, with lesions categorized based on...
Read more Findings and procedure details In this study, we reviewed the imaging findings of 40 patients diagnosed with spinal cord compression. Compressive myelopathy results from external pressure on the spinal cord, which can be localized to the epidural, intradural extramedullary, or intramedullary spaces. Key imaging findings include effacement of epidural fat, displacement of the thecal sac, and spinal cord compression.Epidural Causes Degenerative Disease: Disk Herniation: The most common cause of compressive myelopathy, often leading to cauda equina syndrome. MRI shows continuity between the herniated disk and the donor...
Read more Conclusion Acute myelopathy in a traumatic and nontraumatic setting is a medical emergency requiring urgent evaluation with spinal MRI. A compartmental approach to imaging, combined with clinical and laboratory findings, aids in localizing the lesion and refining the differential diagnosis. Compressive myelopathy, often managed surgically, must be distinguished from noncompressive causes, which have a wide range of etiologies. Familiarity with the MRI findings of various compressive and noncompressive myelopathies is essential for timely and accurate diagnosis, ultimately improving patient outcomes.
Read more References 1.     Parizel PM, van der Zijden T, Gaudino S, et al. Trauma of the spine and spinal cord: imaging strategies. Eur Spine J 2010;19(Suppl 1):S8–S17.2.     New PW, Cripps RA, Bonne Lee B. Global maps of nontraumatic spinal cord injury epidemiology: towards a living data repository. Spinal Cord 2014;52(2):97–109 [Published correction appears in Spinal Cord 2014;52(5):417.]3.     Fehlings MG, Vaccaro A, Wilson JR, et al. Early versus delayed decompression for traumatic cervical spinal cord injury: results of the Surgical Timing in Acute...
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