Document Detail


Pachymeningeal gadolinium enhancement of the lumbar region secondary to neuraxis hypotension.
MedLine Citation:
PMID:  10084184     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN: A case of diffuse pachymeningeal gadolinium enhancement of the lumbar region secondary to neuraxis hypotension is presented. OBJECTIVE: To report a case of diffuse pachymeningeal gadolinium enhancement of the lumbar region and to show the importance of considering neuraxis hypotension in the differential diagnosis of this type of enhancement so as to avoid excessive invasive and noninvasive diagnostic testing. SUMMARY OF BACKGROUND DATA: Diffuse pachymeningeal gadolinium enhancement of the lumbar region secondary to neuraxis hypotension has not been reported previously. METHODS: A case of diffuse pachymeningeal gadolinium enhancement of the lumbar region is presented in the context of clinical signs and symptoms replete with a history of cerebrospinal fluid diversion that strongly suggest neuraxis hypotension. RESULTS: The patient's clinical presentation and history of shunting implicated neuraxis hypotension as a cause of the diffuse dural enhancement. CONCLUSION: Proper attribution of the dural gadolinium enhancement to neuraxis hypotension helped avoid a dural biopsy with its potential attendant morbidity. It is important to consider neuraxis hypotension in the differential diagnosis of diffuse pachymeningeal enhancement occurring anywhere in the central neuraxis to avoid unnecessary diagnostic testing with its attendant morbidity and cost.
Authors:
S L Fedder
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Spine     Volume:  24     ISSN:  0362-2436     ISO Abbreviation:  Spine     Publication Date:  1999 Mar 
Date Detail:
Created Date:  1999-05-04     Completed Date:  1999-05-04     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  463-4     Citation Subset:  IM    
Affiliation:
University of Pennsylvania School of Medicine, Philadelphia, USA. slfedder@aol.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Biopsy
Diagnosis, Differential
Female
Gadolinium / diagnostic use*
Humans
Image Enhancement / methods*
Intracranial Hypotension / diagnosis*,  etiology
Lumbosacral Region / pathology*
Magnetic Resonance Imaging*
Meninges / pathology*
Spinal Cord Diseases / complications,  diagnosis*
Chemical
Reg. No./Substance:
7440-54-2/Gadolinium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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