Patient was treated with high dose steroids, and re-imaged one month later.
On this follow up scan, the conus is even more hyperintense and expanded. The area of enhancement has also increased, and note the increased vascularity of the pial vessels leading up to the lesion. On the axials, a small non-enchancing necrotic area has developed on the right side of the lesion. New enhancement of the cauda roots is also seen, suggesting leptomeningeal dissemination.
An interesting associated finding is thoracic epidural lipomatosis secondary to the high dose steroids. The proliferation of epidural fat dorsal to the thoracic cord causes the CSF anterior to the cord to be effaced (compare with original study).