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Spinal subdural enhancement after suboccipital craniectomy
D W Shaw1, E Weinberger, D K Brewer
1Department of Radiology, University of Washington, Seattle, USA.
AJNR. American Journal of Neuroradiology
|August 1, 1996
Summary
Transient intraspinal subdural enhancement after posterior fossa tumor resection can mimic tumor spread on MRI. This enhancement is typically benign and resolves over time, reducing false-positive diagnoses of metastatic disease.
Area of Science:
- Neuroradiology
- Pediatric Oncology
- Neuro-oncology
Background:
- Suboccipital craniectomy for posterior fossa tumors is common in children.
- Spinal MR imaging is used for staging and detecting metastatic disease.
Purpose of the Study:
- To characterize transient intraspinal subdural enhancement after posterior fossa tumor resection.
- To differentiate this enhancement from subarachnoid tumor spread on MR images.
Main Methods:
- Retrospective review of 10 pediatric patients' imaging and medical records.
- Inclusion of one additional case from another institution.
Main Results:
- Four of 10 patients showed intraspinal subdural enhancement 6-12 days post-surgery.
- Enhancement resolved in follow-up MR studies without treatment.
- CT myelography in one patient showed no subarachnoid lesions.
- No metastases developed during 2.5-3.5 year follow-up.
Conclusions:
- Intraspinal enhancement is likely extraarachnoid/subdural and transient.
- Awareness of this finding reduces false-positive metastatic disease diagnoses.
- Preoperative spinal staging is recommended for these patients.