Clinical question: NMO patient. Signs and symptoms: Previous longitudinal transverse myelitis in cervical spine. Pre-and post enhanced brain MRI:There are no prior exams for comparison.Diffusion-weighted images are negative.Examination demonstrates a single focus of flair hyperintensity in a linear fashion in the periventricular white matter of left anterior temporal lobe which demonstrates enhancement in a multi-branch pattern and with a prominent main consistent with a very small developmental venous anomaly.The overall anatomical morphology and signal intensity of brain parenchyma remains otherwise within normal on all MRI sequences. Post enhanced images are also negative for any additional foci of parenchymal or leptomeningeal enhancement.Calvarium and soft tissues of the scalp are unremarkable.Unremarkable images through the orbits and including axial fat sat post enhanced series.All paranasal sinuses and bilateral mastoid air cells and middle ear cavities demonstrate normal pneumatization signal pattern.Pre-and post enhanced cervical MRI:No prior exams for comparison.Examination demonstrates a large focus of T2/T2 stir hyperintensity of the cervical cord and extending from mid C3 inferiorly to T1. The finding is associated with significant decreased cord caliber and consistent with myelomalacia. There is no evidence of abnormal enhancement of the cervical or the uppermost visualized thoracic cord.There is evidence of prior multilevel posterior laminectomy from C3 through C6.The signal intensity and the alignment of vertebral column is otherwise unremarkable. There is no evidence of spinal canal or neural foraminal compromise/stenosis at any level.Pre-and post enhanced thoracic MRI:There is normal caliber and signal intensity to thoracic cord and without detectable abnormal enhancement.There is normal signal intensity and alignment the vertebral column without abnormal enhancement.There is no evidence of neural foraminal or central spinal compromise or stenosis at any level.Unremarkable perispinal soft tissues.
1.Pre-and post enhanced brain MRI demonstrate no evidence of demyelinating disease. A small left anterior temporal developmental venous anomaly is identified. Unremarkable pre-and post enhanced brain MRI otherwise.2.Pre-and post enhanced cervical MRI demonstrates a long segmental myelomalacia and decreased cord caliber extending from C3 to T1 and without abnormal enhancement. Findings consistent with chronic changes of a prior multilevel transverse myelitis. Expected postoperative changes of multilevel posterior laminectomy without spinal canal or neural foraminal compromise at any level.3.Unremarkable pre-and post enhanced thoracic MRI.