| Intradural lumbar varix resembling a tumor: case report of a magnetic resonance imaging-based diagnosis. | |
| | |
MedLine Citation:
|
PMID: 20628334 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
STUDY DESIGN: Review the presentation and diagnosis of a lumbar intradural varix. OBJECTIVE: To report an innovative magnetic resonance imaging (MRI) technique that enabled radiographic diagnosis in a rare case of symptomatic lumbar intradural varix. SUMMARY OF BACKGROUND DATA: Lumbar variceal veins rarely occur intradurally, and may radiographically mimic nerve-sheath tumors. These lesions are typically diagnosed at surgery performed due to suspicion of tumor. METHODS: A 55-year-old man presented with radicular lower back pain and normal neurologic examination. MRI revealed an ellipsoid intradural enhancing mass at the L2 level. The patient refused to undergo the surgical procedure that was recommended. Over 2-year follow-up, symptoms resolved together with weight reduction. Repeat MRI revealed an unchanged lumbar lesion in addition to engorged epidural and intradural veins, thought to be related to outflow obstruction secondary to past right nephrectomy and obliterated inferior vena cava. Breath-holding and Valsalva maneuvers during MRI caused a change in the shape of the intradural lesion. RESULTS: The patient's refusal to undergo surgery led to noninvasive assessment of his lumbar spinal pathology. Diagnosis of nonthrombosed intradural varix was established on MRI-based detection of a change in the shape of the lesion following breath-hold and Valsalva maneuvers. CONCLUSION: We diagnosed a nonthrombosed intradural varix by demonstrating a change in the lesion's shape on MRI, following breath-hold and Valsalva maneuvers. This is the first report of nonpathologic, purely radiologic diagnosis of such a lesion. This is a relatively simple, noninvasive method of evaluating these patients. |
| | |
Authors:
|
Iddo Paldor; John M Gomori; Alexander Lossos; Ido Yatsiv; Jose E Cohen; Eyal Itshayek |
Related Documents
:
|
23690394 - Comparison of echocardiographic and cardiac magnetic resonance imaging in hypertrophic ... 19703664 - Lumbar magnetic resonance imaging hypolordosis in symptomatic patients: association wit... 16552534 - In vivo quantification of human lumbar disc degeneration using t(1rho)-weighted magneti... 10795544 - Mr imaging of lumbar facet joint synovial cysts. 10193214 - The relevance of clinical and radiological measurements in predicting difficulties in f... 1403024 - Magnetic resonance imaging follow-up in creutzfeldt-jakob disease. |
Publication Detail:
|
Type: Case Reports; Journal Article |
Journal Detail:
|
Title: Spine Volume: 35 ISSN: 1528-1159 ISO Abbreviation: Spine Publication Date: 2010 Aug |
Date Detail:
|
Created Date: 2010-08-04 Completed Date: 2010-11-12 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 7610646 Medline TA: Spine (Phila Pa 1976) Country: United States |
Other Details:
|
Languages: eng Pagination: E864-6 Citation Subset: IM |
Affiliation:
|
Department of Neurosurgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Diagnosis, Differential Epidural Space / blood supply* Humans Low Back Pain / diagnosis* Lumbar Vertebrae / blood supply* Magnetic Resonance Imaging Male Middle Aged Spinal Cord Neoplasms / diagnosis* Varicose Veins / diagnosis* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Magnetic Resonance Imaging and Electromyography to Measure Lumbar Back Muscle Activity.
Next Document: The Evaluation of Bladder Symptoms in Patients With Lumbar Compression Disorders Who Have Undergone ...