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Age: 32

Sex: Male

Indication: Trauma, right occipital condyle fracture on prior CT

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Case #5


Findings

  • Large right central disc herniation at C3-C4, which contacts and deforms the right ventral cord contributing to severe right eccentric spinal canal stenosis and effacement of the right subarticular zone
  • Central cord signal abnormality at and just inferior to the C3-C4 disc herniation
  • T1/T2 hyperintense ventral epidural collection spanning C1-C3, measuring up to 3 mm in thickness
  • No T2/STIR hyperintensity in the visualized osseous structures
  • Transverse and alar ligaments appear intact
  • Small posterior disc osteophyte complexes and uncovertebral spurring at C4-C5 and C5-C6 contribute to mild spinal canal stenosis and mild left greater than right neural foraminal stenosis
  • Mild left neural foraminal stenosis at C6-C7
  • Left dominant vertebral artery with normal flow-related signal loss in both vertebral arteries


Diagnosis

  • Traumatic disc herniation with spinal cord contusion

Sample Report

Age-indeterminate large right central disc herniation at C3-C4, which contacts and deforms the right ventral cord contributing to severe right eccentric spinal canal stenosis and effacement of the right subarticular zone. Cord signal abnormality at and just inferior to this disc herniation is concerning for contusion in the setting of trauma.

Thin ventral epidural hematoma spanning C1-C3, which measures up to 3 mm in thickness.

The reported right occipital condyle fracture is not well demonstrated on this study. Transverse and alar ligaments appear intact.


Discussion

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Images

Large disc herniation at C3-C4 with an associated traumatic cord contusion (red arrow). Ventral epidural collection spanning the levels of C1-C3 which appears hyperintense on both T1 (image to the left) and T2 (image in the middle) weighted sequences and does not demonstrate signal suppression on STIR (image to the right), consistent with an epidural hematoma.



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