Neuroimaging clinics of North America
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This article summarizes myelopathy and radiculopathy caused by different viruses. The cases described are divided into three categories: acute myelitis and radiculitis, postinfectious myelopathy and radiculopathy, and chronic myelopathy. ⋯ Magnetic resonance (MR) imaging is an essential tool in diagnosis. However, because imaging findings are often nonspecific, consideration of a combination of diagnostic procedures, including the clinical course, symptoms, and laboratory data, is necessary for making a correct diagnosis.
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Inflammatory and infectious disorders of the spine in children are less common than in adults, and are usually categorized according to location into (1) those predominantly affecting the spinal cord; (2) those predominantly affecting the nerve roots and meninges; and (3) those predominantly affecting the vertebrae, discs, and epidural space. Disorders primitively involving the spinal cord may be grouped into 2 basic categories: (1) inflammatory (represented by acute transverse myelopathy) and (2) infectious (ie, bacterial, viral, fungal, or parasitic). Inflammatory spinal cord diseases are more common than primitive spinal cord infection.
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The imaging features of spinal parasitic diseases and other rare infections are herein discussed. These diseases are distributed worldwide, with increased prevalence in areas with poor sanitary conditions and in developing countries. ⋯ Infectious diseases are usually treatable, and early detection is often crucial. A thorough comprehension of the imaging patterns associated with the clinical features, epidemiology, and laboratory results allows the radiologist to narrow down the options for differential diagnosis and facilitates the timely implementation of appropriate therapies.
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Spinal infection is rare. Clinical suspicion is important in patients with nonmechanical neck and/or back pain to make the proper diagnosis in early disease. Before planning surgery, a thorough evaluation of the spinal stability, alignment, and deformity is necessary. ⋯ Biomechanical preservation of the spinal column during and after the infection is a significant issue. Postoperative spine infection is another entity of which spinal surgeons should be aware of. Proper septic conditions with meticulous planning of surgery are essential for successful spine surgery and better outcome.
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Neuroimaging Clin. N. Am. · May 2015
ReviewPediatric and adult spinal tuberculosis: imaging and pathophysiology.
The prevalence of tuberculosis (TB) has increased in developing and developed countries as a consequence of the AIDS epidemic, immigration, social deprivation, and inadequate TB control and screening programs. Spinal TB may be osseous or nonosseous. ⋯ Nonspondylitic spinal TB is less well described in the literature, may develop in the absence of TB meningitis, and is often associated with meningovascular cord ischemia. Radiologists should be familiar with the spectrum of imaging findings, allowing early diagnosis and treatment of this serious condition.