MR-IMAGING RELATED TO PM FINDINGS IN ANGIODYSGENETIC MYELOMALACIA - ACASE-REPORT

In a 65-year-old patient with slowly progressive myelopathy of the low er spinal cord MRI revealed slight thickening of the conus medullaris and discrete serpiginous areas of low signal intensity in contact to t he surface of the myelon. The T2-weighted axial images demonstrated a zone of high signal intensity within the center of the lumbosacral cor d. These findings corresponded to the results of autopsy: cord enlarge ment, dilatation of wallthickened and partially thrombosed pial veins, edema, damage of the myelin sheath with development of foam cells, ar eas of hemorrhage and necrosis. Although myelography and spinal digita l subtraction angiography had been normal in this case we assume that perhaps a spinal dural av-fistula may have been the cause of MR- and p athological findings which indicate an angiodysgenetic myelomalacia (M orbus Foix-Alajouanine). The pathogenesis of spinal dural av-fistulas is discussed in order to explain why angiography has been negative.