Compression of brain. Cord edema. MRI thoracic spine:There is accumulation of a collection behind and around the cord which is high signal on T1 and T2 STIR throughout the thoracic spine but predominantly along the upper thoracic spine. This is associated with the diffuse enhancement. There is effacement of spinal fluid ventral and posterior to the spinal cord especially at the T3 vertebral body level. There is abnormal signal within the spinal cord centrally from the cervical cord down to T8 level.The thoracic vertebral bodies are appropriate in the overall alignment and height. There are bilateral pulmonary opacities with pleural effusions. Lumbar spine:Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. The conus medullaris on sagittal imaging is grossly intact. No abnormal enhancing lesions are appreciated in the lumbar spine.At L5-S1 there is no significant compromise to spinal canal or neural foramina.At L4-5 there is no significant compromise to spinal canal or neural foramina.At L3-4 there is no significant compromise to spinal canal or neural foramina.At L2-3 there is no significant compromise to spinal canal or neural foramina.At L1-2 there is no significant compromise to spinal canal or neural foramina.
1.Suspect combination of epidural lipomatosis, epidural venous engorgement and possibly epidural fluid in the thoracic spine (predominantly upper thoracic) associated with compression of the thecal sac.2.Extensive central cord signal abnormality (C3-T8). Differential considerations include pre-syrinx and venous congestion. The distribution of the cord signal abnormality does not match the vascular distribution of a specific spinal artery. Thus cord infarct is less likely here.3.Bilateral pulmonary opacities with pleural effusions. Please correlate with chest x-ray findings.