Nondysraphic cervical intradural lipoma

A series of nine cases of intradural spinal lipomas presenting in childhood or infancy are discussed. In all instances, associated congenital defects and a history of insidious neurological deficit were characteristic findings. In seven of the nine cases a subtotal removal of the intradural lipoma was accomplished, with resulting improvement in the neurological condition. In all instances the pathological interpretation of the lesion was that of an adult type of lipoma. Despite the benign connotations of lipoma, total surgical removal of these lipomas occurring intradurally has often been found not feasible and is probably not necessary. The inclusion of lipoma tissue within the substance of the spinal cord and nerve roots renders manipulation and excision extremely hazardous in terms of retaining the integrity of the nervous structures involved. In these instances subtotal surgical removal and decompression have proven beneficial in all instances in this series. Although exaggeration of neurological deficit may occur postoperatively, if the above surgical principles are adhered to, this deficit is not necessarily of a permanent nature.

Download Full-text

Intradural Lipoma at the Craniocervical Junction Presenting with Progressing Hemiparesis: A Case Report

Case Reports in Neurology ◽

10.1159/000500565 ◽

2019 ◽

Vol 11 (2) ◽

pp. 183-188

Author(s):

Takuro Inoue ◽

Hisao Hirai ◽

Ayako Shima ◽

Fumio Suzuki ◽

Masayuki Matsuda ◽

...

Keyword(s):

Spinal Cord ◽

Pediatric Population ◽

Adult Population ◽

Spinal Dysraphism ◽

Craniocervical Junction ◽

Suboccipital Craniotomy ◽

Benign Nature ◽

Intradural Lipoma ◽

Radiological Studies ◽

Dorsal Medulla

Intradural spinal lipomas are rare in an adult population. They are mostly asymptomatic and usually associated with spinal dysraphism in a pediatric population. We report a rare case of spinal lipoma without dysraphism and with progressing hemiparesis. A 60-year-old woman had incidental lipoma at the craniocervical junction observed for more than 5 years. Recently, she developed right-sided hemiparesis and sensory disturbance. Radiological studies revealed a large lipoma compressing the dorsal medulla and C1–C2 spinal cord. Standard midline suboccipital craniotomy and C1 laminectomy were performed, and the lipoma was removed subtotally. The lipoma showed severe adhesion to the dorsal medulla and C1 spinal cord; therefore, the excision was limited as internal debulking. Her neurological deficit subsided within 6 months after the decompressive surgery. Considering the benign nature of lipoma, internal decompression is a reasonable management for this lesion.

Download Full-text