Spinal Hemangioblastomatosis

These images demonstrate on first glance innumerable tiny flow voids surrounding the cauda equina which may lead one to consider a dural arteriovenous fistula. Post contrast images show that there are innumerable avidly enhancing masses which were predominantly isointense to CSF on noncontrast images. The differential includes drop metastases, schwannomatosis, or hemangioblastomas in a patient with Von Hippel Lindau (VHL). This patient had known VHL which clinches the diagnosis of spinal hemangioblastomatosis.