|
Fig 3. Nidus and segmental interruption of tracts (patient 3, DTI25d). A 23-year-old man presented with bilateral upper limb paresthesia, predominantly on the right side with a sensory deficit. MR imaging showed edema of the cervical spinal cord around the cervical AVM nidus at C2-C3, without any sign of hemorrhage. Angiography revealed a nidus inside the right hemicord, posteriorly located, fed by the pial network arising from the right vertebral artery. First embolization was followed by a clinical improvement of the right upper limb and regression of the T2 hyperintensity on MR imaging. A second session of embolization was performed 1 year later.
A, The third (and last) angiogram performed 3 years 9 months after the onset of the symptoms was not followed by embolization.
B, MR imaging performed at that time with DTI showed T2-hyperintensity inside the inferior part of the nidus corresponding with the embolized part of the nidus.
C, FT25d showed segmental interruption of the tracts of the right posterior column (arrowhead) as could be verified by counting the tracts at the level of the lesion (681) and below it (1017; ratio: lesion level/caudal to lesion = 0.67). The remaining tracts of the lateral column and the midline were slightly shifted showing a mild mass effect on the midline.
|