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Case No. 693
2024-08-01~2024-08-31
출제자 : 황인평
Hit : 323
| Period | 2024-08-01~2024-08-31 |
|---|---|
| Diagnosis | (dorsal) arachnoid web |
| Gender |
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| Age | 49 |
| Clinical information | 수개월 전부터 악화되는 명치~배꼽부위 감각저하를 주소로 내원한 49세 남자입니다. 진단은 무엇일까요? |
| Discussion | (dorsal) arachnoid web 수술소견: T7보다 위쪽으로하여 thickening된 arachnoid web이 존재했음. 이 부분을 microscissor 이용해서 제거하였음. ventral dura exploration을 했으나 dural tear는 없었음. cord herniation은 없었음. 해설) IDEM bands of arachnoid tissue that can extend to the pial surface of the spinal cord, causing a focal dorsal indentation of the cord Most often develops at the upper thoracic level. Imaging finding: - “Scalpel Sign”: anterior displacement of the thoracic cord creating a larger dorsal CSF space - syringomyelia above or below the level of cord indentation - webs themselves are rarely demonstrated on imaging DDx.: - dorsal arachnoid cyst: marginated walls, the presence of smooth wide scalloping of the cord surface, fill slower than the remainder of the subarachnoid space on myelography - ventral spinal cord herniation: focal deformity along the ventral aspect of the cord is often demonstrated Reference Reardon MA et al. AJNR Am J Neuroradiol. 2013;34(5):1104-10. |
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