Pathophysiology, diagnosis and treatment of intermittent claudication in patients with lumbar canal stenosis

Figure 6 Gadolinium-enhanced magnetic resonance imaging of the cauda equina edema in lumbar canal stenosis. A 73-year-old man complained of weakness and numbness of the lower extremities after walking about 300 m, but no obvious sensory loss and muscle weakness was noted. Precontrast T1-weighted (500/35) sagittal (A) and axial (C) conventional spin echo MR image indicated a diagnosis of LCS at L4/5 disc level (arrows). T1-weighted (500/35) sagittal (B) and axial (D) Magnetic resonance image acquired at L4/5 disc level obtained after 0.1 mmol/kg intravenous Gd-DTPA administration showing the generalized central canal stenosis as well as punctuate areas of intrathecal enhancement (arrows) indicating a breakdown in the blood-nerve barrier. Reproduced with permission from Kobayashi et al[46].