Meningeal disorders
Wagner M., Klein JC.
Meningeal disorders of the spine form a heterogenous group of diseases, affecting the spinal cord and its nerve roots through their intimate contact. Meningeal disease can, at times, present with back pain only. However, neurological symptoms are the more common manifestation leading to diagnosis, be it through compression of the spinal cord or of the spinal nerves. MRI is the imaging modality of choice when meningeal disease of the spine is suspected. Wherever possible, imaging studies should precede diagnostic lumbar puncture, because contrast enhancement of the dural sac can occur subsequent to lumbar puncture. If imaging is performed after lumbar puncture, it may be impossible to distinguish between enhancement through meningeal disease and transient changes subsequent to opening of the dural space.