By Holger Pettersson MD, PhD, Derek C. F. Harwood-Nash MB, ChB, FRCP(C) (auth.)
To examine the phenomenon of affliction with out books is to sail an uncharted sea. whereas to check books with out sufferers isn't to visit sea in any respect. Sir William Osler Over a interval of 5 years, the impression of computed tomography (CT) on pediatric neuroradiology on the clinic for unwell young children, Toronto, has been, as anticipated, within the overview of the mind and its abnormalities. Concurrent with this software was once the creation of Metrizamide (Amipaque, Nyegaard & Co. AS, Oslo, Norway), a water-soluble CSF distinction medium, used essentially as a myelog raphic agent. the following software of the wide-aperture CT scanner to imaging of the backbone in youngsters supplied striking advances within the medical administration of spinal sickness considering that CT is much extra actual than typical neuroradiologic tactics. The com bination of CT and Metrizamide additional another size to the imaging of the backbone and of the spinal twine and nerve roots. Such spinal CT and CT Metrizamide myelography in young ones now occupies an important a part of daily pediatric neuroradiologic perform. they've got dramatically stronger our figuring out of the conventional anatomy and pathologic entities of the backbone and its contents in little ones; have altered and superior the surgical administration of such illnesses; and feature considerably enhanced the medical deal with ment of such illnesses within the specialties of neurosurgery, orthopedic surgical procedure, and genito-urinary surgical procedure . .
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Additional resources for CT and Myelography of the Spine and Cord: Techniques, Anatomy and Pathology in Children
More pronounced changes include meningocele, myelomeningocele (to a considerable extent accompanied by a Chiari malformation), diastematomyelia, and syringohydromyelia. Overgrowth of tissue that was sequestered during fetal growth will result in excessive diffuse fatty tissue or developmental discrete mass lesions, such as dermoid, epidermoid, lipoma, or teratoma. Persistence of the transient open passage in the embryo between the yolk sac and the notochordal canal, will result in a neurenteric cyst.
12. Diastematomyelia and low cord. Girl, 1 month, L3. The two parts of the low cord are connected with strands of neural tissue. From each half there are emerging nerve roots. Posteriorly there is a small amount of lipomatous tissue (arrow). Fig. 13. Diastematomyelia. Girl. JO years, Ll. The two halves of the cord are thin and asymmetrically placed in the same dural sac. 50 CT and Myelography of the Spine and Cord Neurenteric Cyst The neurenteric cyst represents a persistence of the transient open passage (the neurenteric canal of Kovalevsky) at the third embryonic week between the yolk sac and the notochordal canal.
From the age of 6-8 years, the transverse diameter of the cervical canal is only slightly larger than, or of the same size as, that of the cervical vertebral body, as it is in adults (Figs. 9). At this same age the thoracic canal is smaller than the vertebral body, as it is in the lumbar area, where the canal is smallest in relation to the vertebral body (Figs. 7). The shape of the spinal canal is subject to considerable change during growth. In infancy and early childhood the cervical canal is oval with the large diameter transversely, the thoracic canal oval with the large diameter in the sagittal plane, and the lumbar canal oval as in the cervical.