Discussion: There is a T2 hyperintensity of the entire cervical spinal cord. After contrast administration, there is contrast enhancement of the meninges of the entirety of the cervical spinal cord and caudal medulla oblongata, which should not be present. This is interpreted as meningoencephalomyelitis with secondary vasogenic edema throughout the cervical spinal cord and, to a lesser extent, the caudal brainstem. There is obstructive hydrocephalus at the level of the caudal medulla causing an enlarged fourth ventricle, presumed secondary to the meningomyelitits.

CSF Analysis:

A cerebrospinal fluid analysis was performed next because there was evidence of possible meningoencephalomyelitis.


WBC Count: 4,500 to 5,000/cumm (Normal: <5)
RBC Count: Minimal (Normal: <5)
Protein: 1929.1 mg/dl (diluted 1:100). Normal lumbar CSF protein is less than 40 mg/dl.


CSF Slide 1 CSF Slide 2

Question: Is this CSF analysis consistent with neoplasia or inflammation?