 There is an ovoid lesion within the central spinal cord centered at the T1 level that measures up to 21 mm. The mass appears to be peripherally T1 hyperintense and T2 hyperintense centrally with a thin peripheral rim of T2 hypointensity. There is no appreciable enhancement. There are minimal patchy foci of T1 and T2 hyperintensity both above and below the lesion extending from the C7 - T2 levels. There is no significant edema outside this region. The vertebral column alignment is within normal limits. The vertebral body and disc space heights are preserved. The vertebral bone marrow signal is unremarkable. The paravertebral soft tissues are unremarkable. There is a congenitally narrow cervical spinal canal. Superimposed upon this are mild degenerative changes, including small disc-osteophyte complexes and uncovertebral joint arthropathy. These findings result in mild spinal canal stenosis at C4-C5, C5-C6, and C6-C7, as well as moderate to severe bilateral neural foramen narrowing at C5-C6. Within the thoracic spine there are scattered mild degenerative changes including multiple small central disc protrusions, most prominent at T5-T6, where it indents the ventral thecal sac and results in mild spinal stenosis.
1. Findings most compatible with a late subacute spinal cord hematoma or hematomyelia with minimal edema centered at the T1 level, whereby spontaneous hemorrhage, post-traumatic hemorrhage, hemorrhagic infarction, or an underlying cavernous malformation are potential etiologies, for example. An underlying neoplasm is perhaps less likely, given absence of associated enhancement. Nevertheless, follow up imaging would be useful for further characterization.2. Multilevel mild degenerative spondylosis, most prominent at T5-T6, where a disc-osteophyte complex effaces the ventral thecal sac and results in mild spinal stenosis.Findings called to Dr. Ali Ahmer by Dr. Michael Rozenfeld at 4:45pm on 1/14/15. 