Computed tomography of acute spinal epidural hematoma associated with cervical root avulsion

A case of acute spinal epidural hematoma associated with post-traumatic cervical root avulsion is described. Surgical management of this condition depends to a large extent on its early recognition as well as accurate information about its site and extent. Computed tomography is the investigative procedure of choice to evaluate this entity.     

Computed tomography of spontaneous acute cervical epidural hematoma

Cervical spinal epidural hematoma is a rare cause of acute neurologic syndromes including paralysis of various types. Although devastating, it can be successfully treated surgically if recognized early. We report two cases of spontaneous cervical epidural hematoma diagnosed by computed tomography, the first with a plain scan and the second with a scan after intrathecal injection of metrizamide. In both patients the diagnosis was not clinically suspected. Surgery resulted in a dramatic improvement of the neurologic deficit in both cases.     

Computed tomography of duodenal hematoma

As the initial study in cases of abdominal trauma, computed tomography may demonstrate intramural duodenal hematoma as an inhomogeneous, high-attenuation mass associated with obstructive changes. Representative cases show the manifestations of this injury as presented by this technique.     

Computed tomography of spinal chordomas

Computed tomography of 16 spinal chordomas revealed lytic lesions, or lytic and blastic lesions, of 2 or more adjacent vertebrae and a fairly well-delineated soft tissue mass in 16 patients. Intravenous contrast enhancement revealed multiple zones of hypodensity in 5 tumors pathologically proved to contain areas of cystic degeneration. Invasion of the epidural space was noted on computed tomography in 2 vertebral and 7 sacral lesions, and on myelography in 7 vertebral lesions. Computed tomography is ideal for delineation of the soft tissue component of these lesions, detection of sacral lesions at an early stage, planning of surgical excision or irradiation treatment, and detection of recurrence.     

Computed tomography of spinal injuries

Computed tomography images are free of superpositional effects. Therefore, today CT represents the most effective method of evaluating spinal fractures. Clear imaging of the vertebral elements provides a sufficient analysis of stability in most cases. Moreover, in the polytraumatized patient, every region of the body can be evaluated without new positioning. Thus, the sequence of therapy may become obvious within a reasonable amount of time. The 3-column theory has proved to be very effective for evaluation of the remaining stability in spinal fractures.     

Computed tomography of spinal tuberculosis

The computed tomographic (CT) features of nine documented cases of spinal tuberculosis are analyzed. The mechanisms of vertebral involvement are reviewed. The ability of CT to facilitate the diagnosis as well as to delineate the extent of soft tissue involvement is emphasized. The need for increased alertness to the diagnosis of tuberculosis is stressed.     

自发性脊髓硬膜外血肿的MRI诊断

目的 探讨自发性脊柱硬膜外血肿MRI表现特征.方法 对9例自发性脊髓硬膜外血肿的MRI表现作回顾性分析,本组患者均无明显的外伤史,发病后4～24h行MRI检查5例,1～3天行MRI检查3例,5天行MRI检查1例.常规横轴面、矢状面T2WI、TIWI及T2 WI脂肪抑制技术.结果 血肿发生于颈段4例,胸段2例,颈胸交界部2例,腰段1例.9例均表现为脊髓硬膜外梭形,长度7～12cm.血肿位于脊髓正后方4例,脊髓右后方3例,脊髓左后方1例,脊髓正前方1例,脊髓不同程度受压移位,脊髓与血肿间见线条状低信号影.4～24h行MRI检查5例,于T2 WI上呈稍高信号3例,高信号1例,等信号1例;于T11WI上呈等信号3例,等低信号2例.1～3天行MRI检查3例,于T2WI上呈低信号1例,等信号1例,等低信号1例;于T1WI上呈等信号2例,等低信号1例.5天行MRI检查1例,于T2 WI上呈低信号;T1WI上呈稍高信号.9例中T2WI压脂上呈低信号3例,等信号4例,高信号2例.结论 MRI是诊断自发性脊髓硬膜外血肿的最佳检查方法,不仅可以清楚地显示血肿的部位及范围,而且可以清楚地显示血肿新旧程度.     

CT myelography of spontaneous spinal epidural hematoma

A case of so-called spontaneous epidural hematoma is presented. A new constellation of myelographic and CT myelographic signs are described that may assist in localizing a mass within the spinal epidural space.     

Computed tomography in spinal trauma

In a retrospective study of 65 patients with spinal trauma, computed tomography was found to add to plain radiography clinically relevant information in 47 patients. It was most helpful in identifying unsuspected neural arch fractures and in assessing spinal canal narrowing. Computed tomography is of great value in pretreatment evaluation and in follow-up of the patient with significant spinal trauma.     

Computed tomography in spinal tuberculosis

Exhaustive ciinicoradiologic and computed tomographic (CT) analysis of 114 cases of spinal tuberculosis seen between January 1983 and January 1989 is presented. The mechanisms of the spinal involvement are reviewed. CT helped to diagnose cases of spinal tuberculosis in their initial stages. Inaccessible fixed areas of spine were seen with ease on axial sections of CT. The extent and anatomic depiction of soft-tissue involvement as depicted on CT helps surgeons choose the appropriate surgical approach, which may affect future spinal stability.     

Computed tomography of spinal fractures.

Computed tomography (CT) has aided significantly in the diagnosis and management of spinal fractures. The examination is easy, relatively quick, and avoids potentially harmful manipulation. The diagnostic advantages of CT include precise anatomic delineation and indication of extent of fractures, assessment of spinal stenosis, and demonstration of associated peraspinal lesions.     

Computed tomography of spinal cord atrophy

Summary Spinal cord atrophy takes on several different forms which correlate closely with specific clinical features. The majority of them, however, can be categorized into three distinct patterns, diffuse (transverse myelopathy), hemi-(Brown-Sequard syndrome), or anterior (anterior spinal artery syndrome) atrophy. Until recently, the differential diagnosis had been made solely on the neurological examination. We present three cases of spinal cord atrophy, one in each category. Spinal computed tomography with metrizamide appears to be a reliable supporting diagnostic method for spinal cord atrophy.     

Computed tomography of nontuberculous spinal infection

The CT findings in 16 patients with nontuberculous spinal infections were reviewed. The specificity of certain CT features as well as the usefulness of intravenous contrast medium administration are discussed. The associated clinical presentations and predisposing factors are outlined. Emphasis is placed on a combined clinical, radiographic approach in facilitating an early diagnosis.     

Computed tomography of solitary spinal osteochondromas

Solitary osteochondromas rarely occur in the axial skeleton. These benign tumors may cause a variety of symptoms while remaining difficult to recognize by plain radiographic and myelographic studies. We present three cases of solitary osteochondromas of the spine and demonstrate the CT findings of these unusual tumors.