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

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

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.

Publication types

  • Case Reports

MeSH terms

  • Arachnoid / diagnostic imaging*
  • Arachnoid / pathology
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Neuralgia / physiopathology*
  • Pain Measurement
  • Syringomyelia / diagnostic imaging
  • Syringomyelia / pathology*