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Precontrast images demonstrated a thickened cauda equina in both patients. In one patient the conus was ill defined on precontrast images.Post- contrast images demonstrated diffuse enhancement of the cauda equina in both patients as well as enhancement along the surface of the conus.In one patient the nerve roots were clumped and adherent to the walls of the thecal sac as well as to other nerve roots.The clinical presentation of urinary retention,flaccid paraparesis,back and/or leg pain,and"saddle anesthesia"in a patient with AIDS should suggest the diagnosis of CMV polyradiculomyelitis.Although diffuse enhancement of the cauda equina on postcontrast MRI is a nonspecific finding,it would strongly support this diagnosis in the appropriate clinical setting.The diagnosis may be easily missed without the use of a contrast agent. |
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acquired immunodeficiency syndrome
acquired immunodeficiency syndrome myelopathy
cauda equina
cauda equina,enhancement
cauda equina,lesion of
cytomegalovirus infection
gadolinium
ganciclovir
herpes virus
herpes virus infection
MRI
MRI,abnormal
MRI,contrast enhanced
MRI,spinal cord
myelitis
myelopathy
myeloradiculitis
myeloradiculopathy
nerve root enhancement
neuropathology
pain,leg
paraparesis
polyradiculoneuropathy
radicular pain
radiculitis
root lesion,nerve
treatment of neurologic disorder
urinary retention
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