case_images: PMC5551415_01
case_images: (a) T2 sagittal MRI: extensive loculated fluid collections compressing the spinal cord ventrally at T12-L2 and dorsally at T8-T12 level. Note T2 cord signal change within the distal thoracic cord/conus at T11-T12. (b) T1 sagittal MRI without contrast: anterior displacement of the cord from T9-T12 level. (c) T1 Sagittal MRI with contrast: distinct enhancement of the fluid collections at T8-T12, T12-L2 and leptomeninges/nerve roots in the cauda equina
case_images: SNI-8-167-g002.jpg
case_images: PMC5551415_01_SNI-8-167-g002.jpg
case_images: F1
case_images: There were heterogeneous pockets of enhancement along the ventral and dorsal leptomeninges of the cervical and thoracic and lumbar spine (e.g., involving the nerve roots of the cauda equina) [Figure 1].
case_images: (a) T2 sagittal MRI: high signal fluid collection compressing/displacing the conus posteriorly. Note the irregularly thickened/clumped together nerve roots. (b) T2 sagittal MRI: irregularly thickened/clumped together nerve roots of the cauda equina
case_images: SNI-8-167-g003.jpg
case_images: PMC5551415_01_SNI-8-167-g003.jpg
case_images: F2
case_images: A loculated ventral fluid collection within the spinal canal between T12 down to L1-L2 markedly compressed the conus posteriorly [Figure 2].
case_images: Intraoperative images. (a) Tense, thickened dura without any epidural abscess. (b) The dural opening at L2 showed nerve root clumping with very little cerebrospinal fluid egress/phlegmon. (c) Second dural opening at T10 showed purulent discharge. (d) Intradural spinal cord thickening/adhesions
case_images: SNI-8-167-g004.jpg
case_images: PMC5551415_01_SNI-8-167-g004.jpg
case_images: F3
case_images: This phlegmon was tightly attached to the spinal cord and neighboring nerve roots by fibrotic gliotic tissue [Figure 3].