By Holger Pettersson MD, PhD, Derek C. F. Harwood-Nash MB, ChB, FRCP(C) (auth.)
To examine the phenomenon of affliction with no books is to sail an uncharted sea. whereas to review books with no sufferers isn't to visit sea in any respect. Sir William Osler Over a interval of 5 years, the impression of computed tomography (CT) on pediatric neuroradiology on the health facility for ill teenagers, Toronto, has been, as anticipated, within the overview of the mind and its abnormalities. Concurrent with this program was once the advent of Metrizamide (Amipaque, Nyegaard & Co. AS, Oslo, Norway), a water-soluble CSF distinction medium, used essentially as a myelog raphic agent. the next software of the wide-aperture CT scanner to imaging of the backbone in little ones supplied extraordinary advances within the scientific administration of spinal sickness seeing that CT is much extra exact than commonplace neuroradiologic tactics. The com bination of CT and Metrizamide further an additional size to the imaging of the backbone and of the spinal twine and nerve roots. Such spinal CT and CT Metrizamide myelography in youngsters now occupies an important a part of day by day pediatric neuroradiologic perform. they've got dramatically better our figuring out of the conventional anatomy and pathologic entities of the backbone and its contents in teenagers; have altered and better the surgical administration of such ailments; and feature considerably better the medical deal with ment of such illnesses within the specialties of neurosurgery, orthopedic surgical procedure, and genito-urinary surgical procedure . .
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Extra info for CT and Myelography of the Spine and Cord: Techniques, Anatomy and Pathology in Children
3). CT and Myelography of the Spine and Cord meningoceles the CTMM examination will reveal a CSF-filled meninwithout any neural elements. The intraspinal meningocele may be seen lesion within the spinal canal compressing the dural sac and cord In the myelomeningocele the cord may be seen to enter the sac and Fig. 3. Intraspinal meningocele. Girl, 16 years, TI2. A large intraspinal meningocele (arrows) dorsal to the dural sac compresses the dural sac as well as the cord. The concentration of Metrizamide is higher in the dural sac than in the meningocele.
The two halves of the cord are thin and asymmetrically placed in the same dural sac. 50 CT and Myelography of the Spine and Cord Neurenteric Cyst The neurenteric cyst represents a persistence of the transient open passage (the neurenteric canal of Kovalevsky) at the third embryonic week between the yolk sac and the notochordal canal. The persistence of the canal of Kovalevsky is always accompanied by some form of anterior vertebral dysraphism as well as abnormalities of neural elements and of tissue derived from the entoderm, for instance, enteric duplications (Harwood-Nash and Fitz, 1976).
This is due to Fig. 10. Normal' thoracic cord. T4 in an 8-year-old boy. The dural sac is slightly oval with the large diameter in the AP direction. The cord is small, and anteriorly placed in the subarachnoid space and spinal canal. The nerve roots (open arrow) and the anterior spinal artery (black arrow) are visualized. Note the open neurocentral synchondrosis. kyphosis of the thoracic spine and is the only area in which the cord is normally anteriorly placed in the canal. However, before the normal lordosis and kyphosis have developed in the infant, the cord is central in this region.