Presentation
Low back pain, lower extremity weakness, and urinary incontinence.
Patient Data
Sagittal and axial pre- and post-contrast MRI images of the thoracic spine demonstrate an intramedullary nodular lesion. This is a T1 hypointense, T2/STIR hyperintense, peripherally enhancing lesion at the level of T8. There is diffuse edema in the upstream and downstream segments of the spinal cord.
Case Discussion
Neurocysticercosis is an infection of the central nervous system caused by the pork tapeworm Taenia solium. It most commonly occurs in the brain. The spinal forms are usually associated with concomitant intracranial involvement. Isolated spinal cord neurocysticercosis is very rare. MRI has the advantage of higher contrast resolution and can help identify lesions that are not obvious on CT. However, CT is superior in identifying calcified lesions. In the appropriate clinical setting, spinal neurocysticercosis should be suspected in patients with T1 hypointense, T2 hyperintense, or rim-enhancing intramedullary lesions. The cyst with the dot sign is a typical appearance of this condition.
The case shown was proven to be neurocysticercosis by spine biopsy.
This case was submitted in collaboration with Trevor Decker.
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