SpineTF5-Intramedullary Cysticercosis

Clinical Profile

Findings

Discussion

Differential Diagnosis

Suggested Reading

Another image showing the scolex

Clinical Profile:

C/O progressive paraparesis.

Findings:

There is evidence of a fairly well-defined intramedullary lesion having a diameter of approximately 1.0 cms at the D6 level. It is isointense to CSF with an eccentric speck within it and which is isointense to white matter (scolex). There is focal expansion of the cord at this level. This lesion did not enhance following contrast administration (images not available).

Discussion: 

Intramedullary cysticercosis usually are well-defined and are cystic. Visualization of the scolex (Click here to see another image with the scolex) is necessary to clinch the diagnosis. Enhancement patterns are as seen in the brain.

Intradural/extramedullary lesions may also be seen in the spine. Cystic structures may be seen within the subarachnoid space. Homogeneous sheetlike enhancement may be seen within the subarachnoid space/over the surface of the spinal cord (arachnoiditis). Syringomyelia may be evident.

Spinal cysticercosis is usually associated with intracranial cysticercosis.

The differential diagnosis of cystic lesions in the cord may include:

• Syrinx
• Tumor related cysts
• Congenital dilatation of the ventriculus terminalis
• Cysticercosis
• Epidermoids, dermoids, teratomas or neurenteric cysts.

Suggested Reading:

1. Claudia C. Leite, J. Randy Jinkins, Beatriz E. Escobar, Alvaro C. Magalhães , Gilberto C. Gomes, Gabriel Dib, Sergio A. Vargas, Chi Zee, Alyssa T. Watanabe : MR Imaging of Intramedullary and Intradural-Extramedullary Spinal Cysticercosis. AJR 169:1713­1717, 1997.