This patient's history really got to me and it is a very interesting exam to see. The images I posted do not look like the original because I took these with my camera phone off of the computer screen so the T1 and T2 weighted images are not windowed properly but it was the best I could get. You can still clearly see the pathology I am talking about. This young man is only 22 years old, the same age as my brother, so that is why I think I put so much emotion into this study. The parents of this patient were practically having to do everything for him. He had a motorized wheelchair with a joy stick because he had very little use of his upper extremities and had been paralized from the waist down. I assumed he was born like this until I screened him and got his history. Last summer he (being over six feet tall himself) dove head first into an above ground swimming pool and suffered severe trauma to his cervical spine. He had to have surgery fusing C4 to C6 with a large strut graft and fusion plate. His injury paralized him. I felt so much sorrow for him and his family because he was an average everyday young man and because of his injury he will have to endure many hardships from here on out. You could tell that he wasn't happy having to rely on his mother to physically care for him so much and that she was new to all this was apparent too. They let him do what he could on his own and he tried so hard to manuver onto the table using his arms, but that was the reason he had come for the MRI. The patient was having neck pain and bilateral upper extremity weakness. Once we started the scan we could tell the source of the symptoms. The patient has a 15mm cystic appearing intramedullary and intradural mass in the spinal cord at the level of C5 with surrounding edema. The radiologist stated in the report that this could be a neoplastic process or a post traumatic change and suggest a neurosurgical consult. The young age of the patient and the tragic history really made me stop and be thankful for my health and well being. I take so much for granted and patients and stories like these help me get back in focus. This was also a great study to learn from, I had never seen a pathology like this in the spinal cord. It is very interesting. I just wish we knew what happened to some patients post MRI or what the results of the pathology composition were.
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