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Uncommon vascular abnormalities in the spinal canal 2008

General Spine

Huey-Jen Lee, MD,
Jonelle Petscavage, MD, Non ASSR Member
Waseem A Bhatti, MD, Non ASSR Member

Scientific Paper

Purpose

To provide an overview of the imaging features of uncommon vascular abnormalities within the spinal canal beyond arteriovenous malformation.

Methods & Materials

Three cases are discussed and demonstrated with different imaging modalities. Case 1: the patient presented with positional headache and dizziness. MRI of the brain and entire spine was performed. Subsequently, complete myelogram and post myelographic CT of the entire spine were also obtained. Case 2: the patient presented with multiple episodes of infarction. MRI of the brain, MR angiogram and CT Angiogram were performed. Case 3: the patient presented with chronic neck pain and progressive cervical radiculopathy. MRI of the cervical spine and CTAngiogram of neck were obtained.

Results

Case1: the MRI of the brain shows boarderline cerebellar tonsil herniation. The post myelogram CT demonstrated CSF leakage in multiple levels in the lumbar spine. There is venous engorgement extending from T8 to T12 in both MRI and myelogram CT. Case 2: The MRI of the brain reveals multiple bilateral cerebral and cerebellar infarctions and encephalomalacia of the cerebellum bilaterally. The CTA and MRA show a primitive persistent left hypoglossal artery. The bilateral vertebral arteries are small in caliber representing left vertebral artery stenosis and left vertebral artery hypoplasia. Case 3: The MRI of the cervical spine demonstrates right neural foramen narrowing at C4-C5. The CTA shows looping of the right vertebral artery in the right neural foramen causing foraminal stenosis.

Conclusion

Although AVM is the most common vascular abnormality within the spinal canal, knowledge of other uncommon vascular abnormality as demonstrated in our cases is essential.

References

Vlychou M, Georganas M, Spanomichos G, Kanavaros P, Artinopoulos C, Zavras GM. Angiographic findings and clinical implications of persistent primitive hypoglossal artery. BMC Med Imaging. 2003 Jul 23;3(1):2.

Burtis MT et al. Intradural spinal vein enlargement in craniospinal hypotension. Am J Neuroradiol. 2005 Jan;26(1):34-8.

Spelle L et al. Neuroimaging features of spontaneous intracranial hypotension. Neuroradiology. 2001 Aug;43(8):622-7.

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