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Case Reports
. 2020 Apr 11:11:66.
doi: 10.25259/SNI_98_2020. eCollection 2020.

Rare dorsal thoracic arachnoid web mimics spinal cord herniation on imaging

Zaid Aljuboori  1 , Maxwell Boakye  1
Affiliations
Case Reports

Rare dorsal thoracic arachnoid web mimics spinal cord herniation on imaging

Zaid Aljuboori et al. Surg Neurol Int. .

Abstract

Background: Dorsal arachnoid webs (DAWs) are rare clinical entities that can mimic other conditions on magnetic resonance imaging (MRI). Here, we present a case of DAW that was misdiagnosed on MR as a ventral cord herniation.

Case description: A 35-year-old female presented with a 1-year history of lower extremity weakness and numbness. The MRI of the thoracic spine showed ventral cord displacement with syringomyelia. The computed tomography myelogram demonstrated ventral cord herniation. Intraoperatively, the patient had a dorsal thoracic web in the absence of cord herniation. Within 8 postoperative weeks, the patient had improved, and the follow-up MI showed a significant reduction in the syrinx size.

Conclusion: On MR scans, DAWs may look like ventral cord herniation. However, the positive "scalpel sign" and syrinx, the absence of an arachnoid cyst on myelography, and the findings on cine MR help differentiate DAWs from ventral cord herniation.

Keywords: Cerebrospinal fluid; Cyst; Dorsal arachnoid webs; Herniation; Magnetic resonance imaging; Spinal cord; Ventral.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1:
Figure 1:
Magnetic resonance imaging of the thoracic spine (sagittal view) shows the syrinx with dorsal indentation of the cord (arrow).
Figure 2:
Figure 2:
Computed tomography myelogram of the thoracic spine (sagittal view) shows the ventral displacement of the cord (arrow).
Figure 3:
Figure 3:
Intraoperative microscopic view (50×) shows dilation of the dorsal arachnoid with the dorsal arachnoid web.
See this image and copyright information in PMC

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