Abstract
The spinal cord is especially well protected by the surrounding CSF, the meningeal envelopes and the bony spine. Intradural tumors are rare lesions: they include intramedullary and intradural extramedullary tumors (Fischer and Brotchi 1996). In a general hospital, of all spinal tumors only 5% are intramedullary whereas 40% are intradural extramedullary and 55% are extradural. Some tumors may initially be intramedullary and become eventually exophytic, growing out of the medulla (extramedullary ependymoma, extramedullary astrocytoma). On the contrary, some extramedullary intradural tumors may grow into the cord like schwannomas. Finally, primary intradural extramedullary tumors may expand towards the extra-dural space such as schwannomas or meningiomas. Extradural tumors are most often malignant lesions, rapidly evolving and originating from the epidural or latero-vertebral space: they are described in Chapters 19 and 20.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Aryan HE, Farin A, Nakaji P et al. (2004) Intramedullary spinal cord metastasis of lung adenocarcinoma presenting as Brown-Sequard syndrome. Surg Neurol 61:72–76
Backes WH, Mess WH, Wilmink JT (2001) Functional MR imaging of the cervical spinal cord by use of median nerve stimulation and fist clenching. Am J Neuroradiol 22:1854–1859
Backes WH, Nijenhuis RJ, Mull M et al. (2004) Contrast-enhanced MR angiography of the spinal arteries: current possibilities and limitations. Rivista Di Neuroradiologia 17:282–291
Baker KB, Moran CJ, Wippold FJ 2nd et al. (2000) MR imaging of spinal hemangioblastoma. AJR Am J Roentgenol 174:377–382
Balériaux D, Parizel P, Bank WO (1992) Intraspinal and intramedullary pathology. In: Manelfe C (ed) Imaging of the spine and spinal cord. Raven Press, New York, pp 513–564
Balériaux D (1999a) Spinal cord tumors. Eur Radiol 9:1252–1258
Balériaux D (1999b) MRI of spinal cord diseases. Educational CD ROM edited by Lasion, 2nd edn.
Balériaux DL, Neugroschl C (2004) Spinal and spinal cord infection. Eur Radiol 14[Suppl 3]:E72–83
Balériaux D, Brotchi J, Salmon I (2004) Spinal cord tumours: a pictorial essay. Rivista di Neuroradiologia 17:336–348
Bret P, Bougeard R, Saint-Pierre G et al. (1997) Intramedullary subependymoma of the cervical spinal cord. Review of the literature a propos of a case. Neurochirurgie 43:158–163
Brotchi J, Dewitte O, Levivier M et al. (1991) A survey of 65 tumors within the spinal cord: surgical results and the importance of preoperative magnetic resonance imaging. Neurosurgery 29:651–657
Brotchi J (2002) Intrinsic spinal cord tumor resection. Neurosurgery 50:1059–1063
Bydder GM, Brown J, Niendorf HP et al. (1985) Enhancement of cervical intraspinal tumors in MR imaging with intravenous gadolinium-DTPA. J Comput Assist Tomogr 9:847–851
Caviness JA, Tucker MH, Pia SK et al. (1998) Hydrocephalus as a possible early symptom in a child with a spinal cord tumor. Pediatr Neurol 18:169–171
Chan CT, Gold WL (1998) Intramedullary abscess of the spinal cord in the antibiotic era: clinical features, microbial etiologies, trends in pathogenesis, and outcomes. Clin Infect Dis Sep 27:619–626
Colombo N, Kucharczyk W, Brant-Zawadzki M et al. (1986) Magnetic resonance imaging of spinal cord hemangioblastoma. Acta Radiol (Diagn) 769:734–737
Colosimo C, Cerase A, Denaro L et al. (2003) Magnetic resonance imaging of intramedullary spinal cord schwannomas. Report of two cases and review of the literature. J Neurosurg 99[1 Suppl]:114–117
Conill C, Sanchez M, Puig S et al. (2004) Intramedullary spinal cord metastases of melanoma. Melanoma Res 14:431–433
Constantini S, Houten J, Miller DC, et al. (1996) Intramedullary spinal cord tumors in children under the age of 3 years. J Neurosurg 85:1036–1043
De Verdelhan O, Haegelen C, Carsin-Nicol B (2005) MR imaging features of spinal schwannomas and meningiomas. J Neuroradiol 32:42–49
Del Carpio, O’Donovan R (1998) A pattern approach to the differential diagnosis of intramedullary spinal cord lesions on MR imaging. AJR Am J Roentgenol 170:1645–1649
Edal A, Balériaux D, Metens T et al. (1997) Three-dimensional turbo spin echo cervical magnetic resonance myelography. Int J Neuroradiol 3:130–135
Epstein FJ, Farmer JP, Freed D (1992) Adult intramedullary astrocytomas of the spinal cord. J Neurosurg 77:355–359
Epstein FJ, Farmer JP, Freed D (1993) Adult intramedullary spinal cord ependymomas: the result of surgery in 38 patients J Neurosurg 79:204–209
Facon D, Ozanne A, Fillard P et al. (2005) MR diffusion tensor imaging and fiber tracking in spinal cord compression. AJNR Am J Neuroradiol 26:1587–1594
Fine MJ, Kricheff II, Freed D et al. (1995) Spinal cord ependymomas: MR imaging features. Radiology 197:655–658
Fischer G, Brotchi J (1996) Intramedullary spinal cord tumors. Thieme, Stuttgart New York
Fountas KN, Karampelas I, Nikolakakos LG et al. (2005) Primary spinal cord oligodendroglioma: case report and review of the literature. Childs Nerv Syst 21:171–175
Friedman DP, Hollander MD (1998) Neuroradiology case of the day. Myxopapillary ependymoma of the conus medullaris or filum terminale resulting in superficial siderosis and dissemination of tumor along CSF pathways. Radiographics 18:794–798
Graca J, Gultasli N, Brotchi J et al. (2006) Cystic extra-medullary ependymoma. AJNR Am J Neuroradiol 27:818–821
Gupta S, Gupta RK, Gujral RB, et al. (1993) Signal intensity patterns in intraspinal dermoids and epidermoids on MR imaging. Clin Radiol 48:405–413
Hamburger C, Buttner A, Weis S (1997) Ganglioglioma of the spinal cord: report of two rare cases and review of the literature. Neurosurgery 41:1410–1415
Huang JH, Zhang J, Zager EL (2005) Diagnosis and treatment options for nerve sheath tumors. Expert Rev Neurother 5:515–523
Innocenzi G, Raco A, Cantore G et al (1996) Intramedullary astrocytomas and ependymomas in the pediatric age group: a retrospective study. Childs Nerv Syst 12:776–780
Ijaz T, Jones K (1997) Images in clinical medicine. Intramedullary spinal cord metastases. N Engl J Med 336:768
Kahan H, Sklar EML, Donovan Post MJ et al. (1996) MR characteristics of histopathologic subtypes of spinal ependymoma. AJNR Am J Neuroradiol 17:143–150
Kalayci M, Cagavi F, Gul S et al. (2004) Intramedullary spinal cord metastases: diagnosis and treatment — an illustrated review. Acta Neurochir (Wien) 146:1347–1354
Kim YG, Choi GH, Kim DH et al. (2004) In vivo proton magnetic resonance spectroscopy of human spinal mass lesions. J Spinal Disord Tech 17:405–411
Koeller KK, Rosenblum RS, Morrison AL (2000) Neoplasms of the spinal cord and filum Terminale: radiologic-pathologic correlation. Radiographics 20:1721–1749
Komisaruk BR, Mosier KM, Liu WC et al. (2002) Functional localization of brainstem and spinal cord nuclei in humans with fMRI. Am J Neuroradiol 23:609–617
Lahanis S, Vlahos L, Gouliamos A et al. (1993) Arteriovenous malformation of the spinal cord mimicking a tumour. Neuroradiology 35:598–599
Lasjaunias P, Berenstein A, Raybaud C (1992) Surgical neuroangiography V. endovascular treatment of spine and spinal cord lesions. Springer-Verlag, Berlin Heidelberg New York
Le Bihan D (1991) Molecular diffusion nuclear magnetic resonance imaging. Magn Reson Q 7:1–30
Lee M, Epstein FJ, Rezai AR et al. (1998) Nonneoplastic intramedullary spinal cord lesions mimicking tumours. Neurosurgery 43:788–794
Levivier M, Brotchi J, Balériaux D et al. (1991) Sarcoidosis presenting as an isolated intramedullary tumor. Neurosurgery 25:271–276
Li MH, Holtas S (1991) MR imaging of spinal intramedullary tumors. Acta Radiol 32:505–513
Lonjon M, Goh KY, Epstein FJ (1998) Intramedullary spinal cord ependymomas in children: treatment, results and follow-up. Pediatr Neurosurg 29:178–183
Lunardi P, Licastro G, Missori P et al. (1993) Management of intramedullary tumours in children. Acta Neurochir (Wien) 120:59–65
Maiuri F, Iaconetta G, De Divitiis O (1997) The role of intraoperative sonography in reducing invasiveness during surgery for spinal tumors. Minim Invasive Neurosurg 40:8–12
Maiuri F, Iaconetta G, Gallicchio B, Stella L (2000) Intraoperative sonography for spinal tumors. Correlations with MR findings and surgery. J Neurosurg Sci 44:115–122
McCormick PC, Torres R, Post KD et al. (1990) Intramedullary ependymoma of the spinal cord. J Neurosurg 72:523–532
Minami M, Hanakita J, Suwa H, et al. (1998) Cervical hemangioblastoma with a past history of subarachnoid hemorrhage. Surg Neurol 49:278–281
Murphy KJ, Brunberg JA, Quint DJ et al. (1998) Spinal cord infection: myelitis and abscess formation. AJNR Am J Neuroradiol 19:341–348
Nadkarni TD, Rekate HL (1999) Pediatric intramedullary spinal cord tumors: critical review of the literature. Childs Nerv Syst 15:17–28
Nagib MG, O’Fallon MT (1997) Myxopapillary ependymoma of the conus medullaris and filum terminale in the pediatric age group. Pediatr Neurosurg 26:2–7
Nakamizo T, Inoue H, Udaka F et al. (2002) Magnetic resonance imaging of primary spinal intramedullary lymphoma. J Neuroimaging 12:183–186
Nemoto Y, Inoue Y, Tashiro T et al. (1992) Intramedullary spinal cord tumors: significance of associated hemorrhage at MR imaging. Radiology 182:793–796
Osborn AG (1994) Tumors, cysts and tumorlike lesions of the spine and spinal cord. In: Osborn AG (ed) Diagnostic neuroradiology. Mosby, pp 876–918
Parizel PM, Balériaux D, Rodesch G, Segebarth C, Lalmand B, Christophe C, Lemort M, Haesendonck P, Niendorf HP, Flament-Durand J, Brotchi J (1989) Gadolinium-DTPA-enhanced MR imaging of spinal tumors. AJNR Am J Neuroradiol 10:249–258
Patel U, Pinto RS, Miller DC et al. (1998) MR of spinal cord ganglioglioma. AJNR Am J Neuroradiol 19:879–887
Pathi R, Kiley M, Sage M (2003) Isolated spinal cord lipoma. J Clin Neuroscience 10:692–694
Perez-Lopez C, Sarmiento MA, Alvarez-Ruiz F et al. (2004) Paragangliomas of the cauda equina: report of two cases. Neurocirugia (Astur) 15:565–570
Przybylski GJ, Albright AL, Martinez AJ (1997) Spinal cord astrocytomas: long-term results comparing treatments in children. Childs Nerv Syst 13:375–382
Poggi MM, Patronas N, Buttman JA et al. (2001) Intramedullary spinal cord metastasis from renal cell carcinoma: detection by positron emission tomography. Clin Nucl Med 26:837–839
Regelsberger J, Fritzsche E, Langer N et al. (2005) Intraoperative sonography of intra-and extramedullary tumors. Ultrasound Med Biol 31:593–598
Ries M, Jones RA, Dousset V et al. (2000) Diffusion tensor MRI of the spinal cord. Magn Reson Med 44:884–892
Rifkinson-Mann S, Wisoff JH, Epstein F (1990) The association of hydrocephalus with intramedullary spinal cord tumors: a series of 25 patients. Neurosurgery 27:749–754
Russo CP, Katz DS, Corona RJ et al. (1995) Gangliocytoma of the cervicothoracic spinal cord. AJNR Am J Neuroradiol 16:889–891
Quencer RM, Post MJ (1997) Spinal cord lesions in patients with AIDS. Neuroimaging Clin N Am 7:359–373
Santaguida C, Sabbagh AJ, Guiot MC et al. (2004) Aggressive intramedullary melanotic schwannoma: case report. Neurosurgery 55:1430
Santoro A, Piccirilli M, Frati A et al. (2004) Intramedullary spinal cord cavernous malformations: report of ten new cases. Neurosurg Rev 27:93–98
Schwarts ED, Chin CL, Takahashi M et al. (2002) Diffusion-weighted imaging of the spinal cord. Neuroimaging Clin N Am 12:125–146
Schwartz TH and McCormick PC (2000) Non-neoplastic intramedullary pathology. Diagnostic dilemma: to Bx or not to Bx. J Neurooncol 47:283–292
Scotti G, Scialfa G, Colombo N et al. (1987) Magnetic resonance diagnosis of intramedullary tumors of the spinal cord. Neuroradiology 29:130–135
Shimizu T, Saito N, Aihara M et al. (2004) Primary spinal oligoastrocytoma: a case report. Surg Neurol 61:77–81
Slowinski J, Stomal M, Bierzynska-Macyszyn G et al. (2005) Paraganglioma of the lumbar spinal canal-case report. Folia Neuropathol 43:119–122
Sun B, Wang J, Liu A (2003) MRI features of intramedullary spinal cord ependymomas. J Neuroimaging 13:346–351
Sundgren P, Annaertz M, Englund E et al. (1999) Paragangliomas of spinal canal. Neuroradiology 41:788–794
Sze G (1996) Neoplastic disease of the spine and spinal cord. In: Atlas SW (ed) Magnetic resonance imaging of the brain and spine, 2nd edn. Lippincott-Raven, pp 1339–1385
Thron AK, Rossberg C, Mironov A (1988) Vascular anatomy of the spinal cord: neurological investigations and clinical syndromes. Springer-Verlag (Wien), Berlin Heidelberg New York
Timmer FA, Van Rooij WJ, Beute GN et al. (1993) Intramedullary lipoma. Neuroradiology 38:159–160
Tortori Donati P, Rossi A (2005) Tumors of the spine and spinal cord. In: Pediatric neuroradiology. Springer-Verlag, Berlin Heidelberg New York, pp 1609–1653
Tsuchiya K, Fujikawa A, Suzuki Y (2005) Diffusion tractography of the cervical spinal cord by using parallel imaging. AJNR Am J Neuroradiol 26:398–400
Van Goethem JW, Van den Hauwe L, Ozsarlak O et al. (2004) Spinal tumors. Eur J Radiol 50:159–176
Weiner HL, Freed D, Woo HH et al. (1997) Intra-axial tumors of the cervicomedullary junction: surgical results and long-term outcome. Pediatr Neurosurg 27:12–18
Weng TI, Shih FY, Chen WJ et al. (2001) Intramedullary abscess of the spinal cord. Am J Emerg Med 19:177–178
Wilmshurst JM, Barrington SF, Pritchard D et al. (2000) Positron emission tomography in imaging spinal cord tumors. J Child Neurol 15:465–472
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2007 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Balériaux, D., Gültasşi, N. (2007). Intradural Spinal Tumors. In: Van Goethem, J.W.M., van den Hauwe, L., Parizel, P.M. (eds) Spinal Imaging. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-68483-1_18
Download citation
DOI: https://doi.org/10.1007/978-3-540-68483-1_18
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-21344-4
Online ISBN: 978-3-540-68483-1
eBook Packages: MedicineMedicine (R0)