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Need help in reading the MRI report. What is the diagnosis? Pain management options?

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Neurologist, Surgical
Practicing since : 1996
Answered : 138 Questions
Your opinion on the MRI report as enclosed.
What disorder is reported in the MRI
Pain relief Management?
Posted Fri, 20 Apr 2012 in Brain and Spine
Answered by Dr. Praveen K Nath 24 hours later

Thanks for the query.

I have gone through your MRI report in detail. According to the reports, there is a ‘lentiform’ elongated intradural - extramedullary (in the covering of spinal cord) lesion between the third to seventh dorsal spine / vertebral region. As per your reports the possible cause of this lesion are long segment Arteriovenous Malformation (AVM) or Epidural hematoma or neurentric cysts, etc.

In view of these changes my suggestions are:

1. To repeat MRI of cervicodorsal spine with contrast to see for interval changes. If there is increase or reduction in the size here, the likely hood of it being an AVM is very high.

2. If your surgeon suspects AVM, you may need an Intra arterial digital subtraction angiography (IADSA) of spinal. This will confirm/rule out AVM beyond doubts.

3. If it is not an AVM and lesion has become smaller / vanished, then you may not need interventions now. In such cases, it might be better to wait & watch while repeating MRI after 6 months.

Meanwhile take some analgesics as and when you have severe pain. You may also consider pregabalin / amitriptyline under the guidance of your doctor for pain control.

My suggestions have been based on your reports. If you can send me the actual MRI films, I will be able to give you more conclusive information. I wish you to send me the actual MRI films to my attention (addressing Attn: Dr. Praveen K Nath) to YYYY@YYYY

Hope this answers your query. Do accept the answer if you do not have any further query.

Dr. Praveen K Nath XXXXXXX Consultant Neurosurgeon
Above answer was peer-reviewed by
Follow-up: Need help in reading the MRI report. What is the diagnosis? Pain management options? 4 hours later
Thank you sir
I have two follow up question.
1. What is AVM
2. How The IADSA procedure performed?
Answered by Dr. Praveen K Nath 50 minutes later
Thanks for reverting.
An AVM is an arterio venous malformation which is an abnormal bunch of blood vessels in the spinal canal. It is only a remote possibility as per your MRI report which can be ruled out after performing a magnetic resonance imaging scan (MRI scan) of the cervicodorsal spine.
IADSA is intraarterial digital subtraction angiography /spinal angiography. This needs to be done in cases where there is a suspicion of arteriovenous malformations on MRI scan.
However, I would suggest that you get a repeat MRI scan done first. If there is lesion or the lesion has reduced in size, then no intervention is required.
I hope I have answered your query. Please accept my answer if you have no further queries.
Dr Praveen K Nath XXXXXXX Consultant Neurosurgeon
Above answer was peer-reviewed by
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