Gadolinium enhanced, T1–weighted MR image
from a 31–year–old man who had incessant radiating pain within weeks
after a car collision. The large disc protrusion at C5–C6 was rated
a Grade 4 because it completely obliterates the combined anterior
epidural and subarachnoid spaces and pushes the spinal cord
posteriorly against the unyielding lamina and also causes
"recoil"–type compression of the spinal cord. The subarachnoid (CSF)
compartment is rendered black. The epidural sinusoids are markedly
widened by the mass effect of the herniation, also the venous blood
flow is obstructed. This venous "pooling" causes the Gadolinium to
render a strong (white) signal. Behind C6 a small (black = signal
void) artery is seen inside the venous sinus.
©2000 Wolfgang Rauschning, M.D., Ph.D.
Professor of Clinical Anatomy
Department of Orthopaedic Surgery
Reproduction without permission is prohibited http://www.akademiska.se/