Intradural spinal vein enlargement in craniospinal hypotension.
We present a case of craniospinal hypotension in a 45-year-old woman with an associated epidural pseudomeningocele extending the entire length of the spine. The epidural pseudomeningocele was caused by a CSF leak at the T8 level. In addition to typical low-pressure symptoms, the epidural pseudomeningocele caused atypical symptoms characterized by positional thoracic radiculopathy. Craniospinal hypotension was associated with massive cervical epidural venous engorgement, as well as enlargement of the posterior spinal cord vein, which was reminiscent of a dural arteriovenous fistula at CT myelography. Enlargement of the posterior spinal vein is explained by the Monro-Kellie hypothesis, and the spinal analog to enlarged cerebral veins known to be associated with intracranial hypotension.
Burtis
M Todd
MT
Division of Neuroradiology, Department of Radiology, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
Ulmer
John L
JL
Miller
Glenn A
GA
Barboli
Alexandru C
AC
Koss
Scott A
SA
Brown
W Douglas
WD
D003937:Diagnosis, Differential; D004108:Dilatation, Pathologic; D031249:Erdheim-Chester Disease / Q000175:diagnosis; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D019585:Intracranial Hypotension / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008588:Meningocele / Q000175:diagnosis*; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000175:diagnosis; D013116:Spinal Cord / Q000098:blood supply*; D013126:Spinal Nerve Roots; D014057:Tomography, X-Ray Computed; D014648:Varicose Veins / Q000175:diagnosis*; D014680:Veins