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    Go to the top of the page   ID: 20030206170902 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Tethered spinal cord with filum terminale lipoma
    Wolfgang Hirsch. Tethered spinal cord with filum terminale lipoma. PedRad [serial online] vol 3, no. 2.
    URL: www.PedRad.info/?search=20030206170902


    ( There are questions in the CMK-Mode for this topic )

     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Wolfgang Hirsch (Leipzig)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    15 Years  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    Spinal canal / Myelon  

     
     Pediatric Radiology CasesMost likely etiology:

    neoplastic  

     
     Pediatric Radiology CasesHistory:

    15 year-old boy, for 6 months increasing waddling gait. Urinary incontinence recently began. Suggestion of pes cavus on both sides.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    A tethered cord syndrome develops from a fixation of the mostly thickened filum terminale at the sacrum. In dysraphy (myelomeningocele), there is (almost) always a TC. Very often there are lipomas in or around the filum (inclusion tumors).

    The harm usually occurs through the years by slowly ischemic alterations of the conus medullaris, which is particularly harmed through bending motions. Also, the often-called conus low-level is not always to be seen initially. A normal conus level does not therefore necessarily rule out a TC.  

     
     Pediatric Radiology CasesRadiological findings:


    MRI 1 <- view MRI 1

    MRI 1: T1-weighted sag: high signal tumor below the conus medullaris, which is at the level of the 2nd lumbar vertebra. This could be fat or Meth-Hb.













    MRI 2 <- view MRI 2

    MRI 2: T2 weighted without fat saturation: high signal tumor, which fills the spinal canal at the level of the 3rd lumbar vertebra. This could be fat or fluid. Within the conus medullaris there is a widened syrinx/hydromyely seen.













    MRI 3 <- view MRI 3

    MRI 3: T2-weighted with fat saturation: the signal in the filum tumor-inclusion disappears, and the hydromyely remains. Therefore it is surely a tumor with fatty contents.












    MRI 4 <- view MRI 4

    MRI 4: T1-weighted before contrast media: The signal of the tumor has disappeared.












    MRI 5 <- view MRI 5

    MRI 5: T1-weighted after contrast media: A contrast media uptake is not seen.












    MRI 6 <- view MRI 6

    MRI 6: Subtraction images before and after contrast media: A contrast media uptake is not seen.









     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Total constellation (Consens)  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Teratoma, in this MRI-constellation no others.  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Surgery to relieve the cauda is necessary.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

    tethered cord, filum, lipoma, inclusion TM, tethered spinal cord, dysraphy, thickened filum terminale, waddling gait, urinary incontinence, myelomeningocele, filum terminale lipoma, filum terminale, conus terminale, conus terminale lipoma, child, childhood, pediatric radiology  

     
     Pediatric Radiology Cases Cite this article:

    Wolfgang Hirsch. Tethered spinal cord with filum terminale lipoma. PedRad [serial online] vol 3, no. 2.
    URL: www.PedRad.info/?search=20030206170902  

     
     Pediatric Radiology Cases Read similar articles: with corresponding keywords
    in the same field: Spinal canal / Myelon
    or in the region: Spinal canal / Myelon
    or in the tissue/organ:
    or with the etiology: neoplastic
     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     
    Tethered spinal cord with filum terminale lipoma
    Wolfgang Hirsch. Tethered spinal cord with filum terminale lipoma. PedRad [serial online] vol 3, no. 2.
    URL: www.PedRad.info/?search=20030206170902


    ( There are questions in the CMK-Mode for this topic )

     

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    Tethered spinal cord with filum terminale lipoma
    Other cases by these authors:

    Search Wolfgang Hirsch in Medline Wolfgang Hirsch (17)   

    Tethered spinal cord with filum terminale lipoma  
     
    Tethered spinal cord with filum terminale lipoma
    Wolfgang Hirsch. Tethered spinal cord with filum terminale lipoma. PedRad [serial online] vol 3, no. 2.
    URL: www.PedRad.info/?search=20030206170902


    ( There are questions in the CMK-Mode for this topic )

     

    Which diagnosis have other collegues guessed?


    • Astrocytoma
      Votes: 2 (7 %)


    • Metastasis of a medulloblastoma
      Votes: 1 (3 %)


    • Tethered-Spinal-Cord because of inclusion tumor (Lipoma) in the filum terminale
      Votes: 23 (82 %)


    • Hemorrhagic metastasis
      Votes: 1 (3 %)


    • Metastasis of a neuroblastoma
      Votes: 1 (3 %)



        Total answers: 28

     
    Tethered spinal cord with filum terminale lipoma
    Wolfgang Hirsch. Tethered spinal cord with filum terminale lipoma. PedRad [serial online] vol 3, no. 2.
    URL: www.PedRad.info/?search=20030206170902


    ( There are questions in the CMK-Mode for this topic )

     

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    Tethered spinal cord with filum terminale lipoma
    Wolfgang Hirsch. Tethered spinal cord with filum terminale lipoma. PedRad [serial online] vol 3, no. 2.
    URL: www.PedRad.info/?search=20030206170902


    ( There are questions in the CMK-Mode for this topic )

     




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