JAs MedImaging

Meningiomas arising from the coverings of the spinal cord are one of the two most common intradural extramedullary spinal tumors, representing 25-30% of all such tumors.

CLINICAL PRESENTATION
Despite usually being small, due to the confines of the spinal canal, spinal meningiomas can result in significant neurologic dysfunction including motor weakness, sensory deficits, myelopathy, and pain

LOCATION
Spinal meningiomas are not distributed evenly along the canal:

cervical spine: 15%

thoracic spine: 80%

lumbosacral spine: 5%

MRI HALLMARKS
✅ Well-circumscribed intradural extramedullary mass
✅ Iso- to hypointense on T1-weighted images
✅ Iso- to hyperintense on T2-weighted images
✅ Intense, homogeneous post-contrast enhancement
✅ Characteristic “dural tail” may be present
✅ Associated spinal cord compression and edema in advanced cases
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