PMC4040026_01
(a) Pre-operative mid-sagittal short-tau inversion recovery and (b) contrast-enhanced T1-weighted lumbar spine MRI demonstrate a heterogenous enhancing intradural mass from L1 to S1 with some septated fluid/cystic elements. The cauda equina and conus medullaris cannot be identified. There is adjacent cord edema. In retrospect, a dorsal dermal sinus can be seen (arrow, b)
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F1
Pre-operative MRI of the lumbosacral spine [Figure 1a and b] demonstrated a heterogenous enhancing intradural mass extending from L1 to S1.
Pre-operative cervical T2-weighted mid-sagittal magnetic resonance imaging shows holocord edema or syrinx up to the level of the medulla
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F2
MRI of the cervical spine [Figure 2] showed holocord edema or syrinx up to the level of the medulla.
PMC4040026_02
(a) Pre-operative mid-sagittal contrast-enhanced T1-weighted lumbar spine magnetic resonance imaging demonstrates a heterogenous thick rim-enhancing intradural mass from L1 to S1 with multi-septated fluid/cystic components. The cauda equina and conus medullaris cannot be identified. (b) A dorsal dermal sinus tract (arrow) can be seen on sagittal T2-weighted images
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F3
Pre-operative MRI of the lumbosacral spine [Figure 3a and b] demonstrated a heterogenous thick rim-enhancing intradural mass extending from L1 to S1.
Pre-operative thoracic T2-weighted mid-sagittal magnetic resonance imaging shows T2-hyperintensity extending from T4 along the remaining caudal length of the spinal cord
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F4
There was expansion and T2-hyperintense signal from T4 along the caudal length of the spinal cord [Figure 4].
Post-operative T2-weighted mid-sagittal magnetic resonance imaging of the (a) thoracic and (b) lumbar spine at 6 months after surgery shows partial decompression of the dermoid cyst with residual dermoid cyst centered at the L4-5 level. There is interval resolution of the syrinx and improved edema of the spinal cord
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F5
Follow-up MRI shows partial decompression of the dermoid cyst, interval resolution of syrinx and improved spinal cord edema [Figure 5a and b].