title: Intramedullary gadolinium-DTPA enhancement in a patient with cervical spondylotic myelopathy and an associated vascular lesion. Case report.
abstract: Intramedullary enhancement of the cervical spinal cord is rare in chronic compression disease. An accompanying vascular lesion should be considered in such a case. A 59-year-old man presented with severe cervical spondylotic myelopathy. Gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) enhanced magnetic resonance imaging showed intramedullary enhancement at the C5-6 level, which was the most severely compressed level. A right ascending cervical arteriogram demonstrated a spinal arteriovenous fistula (AVF) fed mainly by the C-6 radicular artery and draining from the posterior medullary vein. Surgery was performed to decompress the myelopathy and to obliterate the AVF. Postoperative MR imaging with Gd-DTPA enhancement showed immediate and complete disappearance of the previous enhancement. The intramedullary enhancement presumably resulted from the intraparenchymal hemodynamics due to the AVF.
authors.affiliation: Department of Neurosurgery, Nara Medical University, Kashihara, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Morimoto
authors.forename: T
authors.initials: T
authors.lastname: Yamada
authors.forename: K
authors.initials: K
authors.lastname: Nagata
authors.forename: T
authors.initials: T
authors.lastname: Matsuyama
authors.forename: T
authors.initials: T
authors.lastname: Sakaki