Case of the Week

Axial spine CT (A) through the C6 vertebra shows a left lamina acute fracture (red arrow), without bone displacement and (B) a right epidural space hypodense image at C6 and C7 level (red arrow). Axial T2WI (C) shows an epidural fluid collection with signal identical to CSF (red arrow), with dural sac mass effect, and (D) a large CSF signal fluid collection in the right cervical soft tissues (green arrow). A fast-spin-echo T2-weighted sequence (E and F) confirms dural displacement by the epidural CSF collection, and shows the site of dural tear (blue arrow), absence of intradural roots on the right side (yellow arrowhead), due to traumatic avulsion, and normal left intradural roots (orange arrowheads). This is compatible with traumatic root avulsion and epidural pseudomeningocele with extension to paravertebral space through the foramina (F, pink arrowheads indicate CSF flow artifact at C6–C7).