Presentation
Decreased sensitivity of the lower limbs and midline paresthesia-like burning sensations of the thoracic spine.
Patient Data



Posterior arachnoidal space dilatation measuring 25 x 7 x 7 mm at the T5 level with spinal cord compression of about 50% and a typical scalpel sign. A turbulent CSF flow immediately below this lesion with flow voids on T2 weighted images. Myelopathy at the T3-T4 levels.



Zoomed in version of the sagittal T2 demonstrating a 'perfect' example of the scalpel sign.
Case Discussion
This is a representative case of the scalpel sign and typical dorsal thoracic arachnoid web. This patient requires spinal cord decompression surgery.