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Neuroradiol J. 2016 Oct;29(5):393-5. doi: 10.1177/1971400916656488. Epub 2016 Jun 17.

Dorsal thoracic arachnoid web presenting as neuropathic pain: 'Scalpel' sign found on MRI.

Author information

1
Department of Psychiatry, Hofstra Northwell Health - Staten Island University Hospital, USA rohitaiyer@gmail.com.
2
Department of Neurology, Hofstra Northwell Health - Staten Island University Hospital, USA.
3
Department of Radiology, Hofstra Northwell Health - Staten Island University Hospital, USA.

Abstract

Dorsal thoracic arachnoid webs are due to a deformity in the formation of arachnoid membrane in the spinal arachnoid space. These webs usually occur in the upper thoracic spine and are viewed on imaging as a pathogonomic 'scalpel' sign because of the resemblance on sagittal MRI to a surgical scalpel. We describe a case of a patient with a neuropathic pain presentation. After MR imaging, a focal dorsal indentation of the upper thoracic spinal cord at the T3-T4 level with the scalpel sign was found. This sign indicates that the patient's neuropathic pain was caused by the dorsal thoracic arachnoid web.

KEYWORDS:

Arachnoid web; dorsal thoracic arachnoid web; neuropathic pain; scalpel sign

PMID:
27316566
PMCID:
PMC5033090
DOI:
10.1177/1971400916656488
[Indexed for MEDLINE]
Free PMC Article

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