Surgical Outcome of Intramedullary Spinal Cord Ependymoma

Ependymomas are the most commonly occurring intramedullary spinal cord tumor in adults. With few exceptions these tumors are histologically benign, although they exhibit some biologic variability with respect to growth rate. While unencapsulated, spinal ependymomas are non-infiltrative and present a clear margin of demarcation from the surrounding spinal cord that serves as an effective dissection plane. This video demonstrates the technique of microsurgical resection of an intramedullary ependymoma through a posterior midline myelotomy.The video can be found here: http://youtu.be/lcHhymSvSqU.

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Intramedullary Spinal Cord Ependymoma

Neurosurgery ◽

10.1097/00006123-199902000-00014 ◽

1999 ◽

Vol 44 (2) ◽

pp. 269-269

Author(s):

Kintomo Takakura

Keyword(s):

Spinal Cord ◽

Intramedullary Spinal Cord ◽

Spinal Cord Ependymoma

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Magnetic Resonance Imaging Features of Intramedullary Spinal Cord Tumors with Pathological Correlations

The ASEAN Journal of Radiology ◽

10.46475/aseanjr.v19i1.22 ◽

2013 ◽

Vol 19 (1) ◽

pp. 51-66

Author(s):

Jureerat Thammaroj ◽

Amnat Kitkhandee ◽

Parinyaporn Tumkot ◽

Pichayen Duangtongpol ◽

Sakda Waraosawapati

Keyword(s):

Magnetic Resonance Imaging ◽

Spinal Cord ◽

Magnetic Resonance ◽

Signal Intensity ◽

Imaging Features ◽

Resonance Imaging ◽

Spinal Cord Tumors ◽

Intramedullary Spinal Cord ◽

Cystic Component ◽

Spinal Cord Ependymoma

Objective: The purpose of this study was to determine characteristic imaging findings of intramedullary spinal cord tumor in magnetic resonance imaging (MRI). Material and Methods: We retrospectively analyzed MRI in 15 patients with histologicaly proven intramedullary spinal cord tumors. The demographic data, MRI findings with histological findings were recorded in terms of age, location, length, morphology, signal intensity, the presence or absence of cyst and hemorrhage, enhancement pattern, other associated findings, necrosis, vascular proliferation and WHO grading. Results: Among the 15 patients, spinal cord ependymomas were eccentric 75%, well-define border 62.5% and cervicothoracic spine located 37.5%. Spinal cord astrocytomas were eccentrically located and ill-define border 85.7%, cervicothoracic and thoracic spine located 28.5%. A cystic component was seen in 87.5% of spinal cord ependymoma and 71.5% of astrocytomas. Intratumoral hemorrhage occurred in 75% of spinal cord ependymomas, and 57.1% of astrocytomas. In 12.5% of spinal cord ependymomas, a curvilinear low T2 signal, suggesting marginal hemorrhage, was seen at the upper and/or lower margins of the tumors. Twenty-five percent of spinal cord ependymoma and 57.2% of astrocytomas showed heterogeneous enhancement, while in 12.5% of spinal cord ependymomas, enhancement was homogeneous. Conclusion: Although no statistically significant characteristic MRI feature to distinguish between ependymoma and astrocytoma is detected. By percentage we found that border, length and signal intensity of tumors may help diagnosis. With pathological correlation, all of spinal cord ependymomas are mark hypervascular tumor, but astrocytomas never showed.

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Clinical presentation and surgical outcome of intramedullary spinal cord cavernous malformations

Journal of Neurosurgery Spine ◽

10.3171/2011.11.spine11536 ◽

2012 ◽

Vol 16 (3) ◽

pp. 308-314 ◽

Cited By ~ 12

Author(s):

Xianzeng Tong ◽

Xiaofeng Deng ◽

Huan Li ◽

Zhuang Fu ◽

Yulun Xu

Keyword(s):

Spinal Cord ◽

Mr Imaging ◽

Surgical Outcome ◽

Clinical Presentation ◽

Acute Onset ◽

Intramedullary Spinal Cord ◽

Cavernous Malformations ◽

Recent Onset ◽

Characteristic Imaging ◽

Microsurgical Resection

Object Intramedullary spinal cord cavernous malformations (CMs), once thought to be extremely rare, have been diagnosed more frequently since the advent of MR imaging. In the literature, however, only a few studies include more than 10 cases. The aim of this study was to discuss the clinical presentation of intramedullary spinal cord CMs and the outcome of microsurgery for these histologically benign but clinically progressive lesions. Methods The authors retrospectively reviewed the records of 20 patients who underwent microsurgery for intramedullary spinal cord CMs. All patients had undergone pre- and postoperative MR imaging, and they were all treated using microsurgical resection. The diagnosis of spinal cord CMs was based on pathological criteria. The pre- and postoperative neurological states of the patients were classified according to the McCormick scale and Frankel scale. The microsurgical outcomes are presented and discussed. Results In most cases, CMs can be diagnosed on the basis of MR imaging findings, since these lesions have certain characteristic imaging patterns. Patients with intramedullary spinal cord CMs may present with either a rapid, acute onset of symptoms or slow, progressive neurological decline. The CMs in 19 of 20 patients in this series were totally resected, and most patients neurologically improved postoperatively. As previously reported, the authors confirm that the treatment of choice for symptomatic intramedullary CMs is total removal of the lesion to avoid recurrence and the possibility of further hemorrhage. Conclusions This study has defined the clinical features of symptomatic intramedullary spinal cord CMs. Surgery is the mainstay treatment. Surgical outcome is associated with low mortality with a high probability of functional recovery, especially when symptoms are not severe and are of relatively recent onset.

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