Post traumatic Focal Adhesive Arachnoiditis
referred for magnetic resonance imaging (MRI) of the thoracic spine due to longstanding walking difficulties. His complaints started shortly after he was beaten with a baseball bat in the region of his back. On admission, the patient suffered from disturbed walking scheme with bilateral spastic hypertonia and reduced muscle strength of the lower limbs. Further neurological examination was unremarkable, while laboratory findings were within the range of normal limits. MRI examination showed widespread intradural bands of low T2 signal (Figure 1A C, arrows) showing vivid enhancement (Figure 1D and E, arrows) There was distortion of the thoracic spinal cord, especially at Th7/8 level where the cord was displaced posteriorly (Figure 2A and B, arrows) At this level, the spinal cord showed marked T2 hyperintense signal in keeping with myelomalacia (Figure 2A C, arrowheads) There was cord atrophy below the level of Th8 extending to the conus medullaris (Figure 2A, asterisk) Based on imaging and clinical findings, the diagnosis of post traumatic focal adhesive arachnoiditis was made.
Journal of the Belgian Society of Radiology