Intradural/Extramedullary Lesion, Multiple



Intradural/Extramedullary Lesion, Multiple


Bryson Borg, MD



DIFFERENTIAL DIAGNOSIS


Common



  • CSF Flow Artifact


  • Neurofibromatosis Type 1


  • Neurofibromatosis Type 2


  • Metastases, CSF Disseminated


Less Common



  • Multiple Nerve Sheath Tumors (Multiple, Nonsyndromic)



    • Schwannoma


    • Neurofibroma


  • Meningiomas, Multiple


  • Type 1 DAVF


  • Hemangioblastoma, Spinal Cord


  • Granulomatous Disease


Rare but Important



  • Cysticercosis


ESSENTIAL INFORMATION


Helpful Clues for Common Diagnoses



  • Neurofibromatosis Type 1



    • Multiple, enhancing, bulky, fusiform nerve root masses; may be intradural, extradural, or transdural


    • Associated findings: Extraspinal plexiform neurofibromas, kyphoscoliosis, dural ectasia


    • Suddenly enlarging or painful lesion: Consider malignant degeneration


  • Neurofibromatosis Type 2



    • Multiple, circumscribed extramedullary masses associated with nerve roots, at any location along the spine or cauda equina


  • Metastases, CSF Disseminated



    • Spread from an extraspinal primary (breast, lung, lymphoma/leukemia) or “drop metastases” from a CNS primary (medulloblastoma, ependymoma, GBM)


    • Single/multiple dural- or pial-based enhancing nodules; can become confluent, causing a “sugar coated” appearance


Helpful Clues for Less Common Diagnoses

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Aug 7, 2016 | Posted by in NEUROLOGY | Comments Off on Intradural/Extramedullary Lesion, Multiple

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