INTRADURAL LIPOMAS IN CHILDREN

PEDIATRICS ◽  
1962 ◽  
Vol 29 (6) ◽  
pp. 911-926
Author(s):  
Homer S. Swanson ◽  
Joseph C. Barnett
Keyword(s):  
Spinal Cord ◽  
Neurological Deficit ◽  
Congenital Defects ◽  
Surgical Removal ◽  
Nerve Roots ◽  
Adult Type ◽  
Neurological Condition ◽  
History Of ◽  
Intradural Lipoma ◽  
Subtotal Removal

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.

Primary polymorphous hemangioendothelioma of the spinal cord

2001 ◽  
Vol 95 (1) ◽  
pp. 93-95 ◽  
Author(s):  
Federico Roncaroli ◽  
Bernd W. Scheithauer ◽  
Savvas Papazoglou
Keyword(s):  
Spinal Cord ◽  
Vascular Tumor ◽  
Nerve Roots ◽  
Content Type ◽  
Sensorimotor Deficit ◽  
History Of ◽  
Intradural Extramedullary ◽  
Borderline Malignancy ◽  
Current Experience

✓ A case of polymorphous hemangioendothelioma of the spinal cord is described. This 55-year-old woman presented with an 18-month history of lower-extremity sensorimotor deficit. A magnetic resonance image revealed an enhancing, intradural, extramedullary nodule at the T1–2 level. On gross inspection, the lesion measured 3.5 cm and was firmly attached to spinal cord parenchyma and adjacent nerve roots. It was completely removed. Fourteen months after surgery the patient's neurological deficit had resolved. Polymorphous hemangioendothelioma is a rare vascular tumor of borderline malignancy. Most occur in lymph nodes. None has been reported to occur in the central and peripheral nervous system. Based on current experience, resection and close follow up seems the best therapeutic approach.

Multiple hemangiomas (hemangiomatosis) of the cauda equina and spinal cord

2000 ◽  
Vol 92 (2) ◽  
pp. 229-232 ◽  
Author(s):  
Federico Roncaroli ◽  
Bernd W. Scheithauer ◽  
H. Gordon Deen
Keyword(s):  
Spinal Cord ◽  
Cauda Equina ◽  
Conus Medullaris ◽  
Unique Case ◽  
Nerve Roots ◽  
Thoracic Spinal Cord ◽  
Content Type ◽  
Thoracic Spinal ◽  
History Of ◽  
Leg Weakness

✓ A case of multiple hemangiomas of the cauda equina nerve roots, conus medullaris, and lower spinal cord is described. The 74-year-old male patient presented with a 9-month history of progressive bilateral leg weakness. He had a history of lymphoma at the age of 39 years and renal cell carcinoma in his early 40s. Neither disease was evident at the time of this presentation. A magnetic resonance image revealed multiple enhancing nodules in the cauda equina region as well as on the pial surface of the lower thoracic spinal cord and conus medullaris. The patient underwent an L2–3 laminectomy. Cauda equina nerve roots were found to be studded with numerous purple nodules, the largest measuring 6 to 8 mm. The nodules were adherent to nerve roots from which they could not be resected. Two lesions were histologically examined and found to be capillary hemangiomas. Twelve months into an uneventful postoperative course, the patient is neurologically unchanged. This unique case might represent a distinct form of hemangiomatosis confined to the cauda equina nerve roots and spinal cord.

scholarly journals Cervical Spine Myelopathy from Metalloma Association with Chronic Retention of a Bullet

2021 ◽  
Author(s):  
Piyawat Bintachitt ◽  
Ratanaphorn Chamnan ◽  
Weera Chaiyamongkol ◽  
Wongthawat Liawrungrueawng
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Gunshot Wound ◽  
Foreign Bodies ◽  
Surgical Removal ◽  
History Of ◽  
Spine Fixation ◽  
Cervical Spine Fixation ◽  
Cervical Spine Myelopathy

     A Civilian gunshot wound associated with metallosis in the cervical spine region was an extremely rare case; hence, the clinician had difficulty with diagnosis and surgical treatment.      A 57–year-old gentleman had a history of a gunshot wound injury going back 30 years. He presented with neck pain, progress of paresthesia of upper extremities and progressively difficult ambulation for 3 months. Radiographic and pathological diagnosis from tissue of the 7th paravertebral of the cervical spine showed foreign bodies consistent with metallosis. The patient showed improvement of symptoms after posterior cervical spine fixation and decompression. He had full recovery at 1 year follow up.      Metallosis can occur in cases of chronic exposure to lead and metals. The results of this chronic process of metallosis will develop to metalloma, which then compresses the spinal cord and develops into myelopathy. The patient had a bullet, or piece of metal at the cervical spine, so surgical removal was performed to prevent further compression of the spinal cord from metalloma.

scholarly journals Calving-related intradural avulsion injuries of the thoracolumbar spinal nerve roots in a calf

2020 ◽  
Vol 32 (6) ◽  
pp. 968-971
Author(s):  
Hayate Nishiura ◽  
Shino Jou ◽  
Toru Ogata ◽  
Hiroki Kondo ◽  
Toshihiro Ichijo ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cord Compression ◽  
Spinal Nerve ◽  
Spinal Nerve Roots ◽  
Nerve Roots ◽  
Traumatic Neuroma ◽  
Old Japanese ◽  
History Of ◽  
Nerve Fascicle ◽  
Calving Difficulty

Calving difficulty may lead to traumatic peripheral nerve injury. A male, 8-mo-old, Japanese Black calf with a history of secondary dystocia as a result of fetal gigantism had lameness and gait disturbance. At autopsy, multifocal dural thickening with adhesions to the adjacent spinal cord was observed at T12–13 and L4–5 vertebral levels. Microscopically, numerous traumatic neuroma-like fascicles of nerve twigs were embedded in the dura mater with abundant collagenous connective tissue. By immunohistochemistry, axons and Schwann cells were confirmed in each nerve fascicle. Our observations suggest that avulsion injuries in the preganglionic fibers of the spinal nerve roots, and secondary spinal cord compression, resulted in the development of neurologic signs.

scholarly journals Spinal synovial cysts causing neurological deficit

2018 ◽  
Vol 21 (2) ◽  
pp. 126-129
Author(s):  
Emerson Magno F. De Andrade ◽  
Raphael Vicente Alves ◽  
Mariano Ebran Fiore ◽  
Airton Batista De Araújo Jr ◽  
Antônio Carlos Montanaro ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Differential Diagnosis ◽  
Neurological Deficit ◽  
Nerve Root ◽  
Clinical Presentation ◽  
Cord Compression ◽  
Surgical Removal ◽  
Cervical Cyst ◽  
Gradual Development ◽  
Synovial Cysts

Synovial cysts of the spine are usually asymptomatic, rarely causing nerve root or spinal cord compression. The authors report on two cases of spinal synovial cysts. One patient harbored a cervical cyst causing myelophaty, and a secondpatient had a lumbar cyst with gradual development of radiculopathy. In both cases the patients had improvement of the symptoms and good outcome after surgical removal of the cysts. Synovial cysts should be considered in the differential diagnosis of any spinal extradural masses. The literature is reviewed and the etiological, clinical presentation, diagnosis and treatment are discussed.

Imaging of Hemispheric Brain Gangliogliomas

1997 ◽  
Vol 10 (5) ◽  
pp. 563-568 ◽  
Author(s):  
F.S. Finizio
Keyword(s):  
Glial Cells ◽  
Residual Life ◽  
Focal Epilepsy ◽  
Clinical History ◽  
Good Prognosis ◽  
Surgical Removal ◽  
History Of ◽  
Cns Tumours ◽  
Subtotal Removal ◽  
Neuroradiological Diagnosis

The group of gangliogliomas (GGI) and ganglioneuromas (GGN) includes tumours composed of nerve cells and glial cells, usually astrocytes. In this sense, they differ from most primary CNS tumours in which only the glial cells show malignant change. The differentiation between GGIs and GGNs is histological: if glial cells predominate, the lesion is called a “ganglioglioma”, when neuronal elements predominate, the term “ganglioneuroma” is used. Nevertheless, these two tumors types should be considered a single entity. Patients of all ages are affected, but the majority of tumours arise in the first two decades of life. The temporal lobe is a favorite site. The clinical history of these slow-growing neoplasms is usually one of long-standing focal epilepsy. The neuroradiological aspects of 13 hemispheric GGIs are described. Calcifications were seen in 5 case. All cases were histologically verified. Three characteristic neuroradiological features were noted: 1) mainly cystic with a solid portion in 6 cases; 2) entirely cystic or with a mural nodule at the wall of the cyst in 3 cases; 3) entirely solid in 4 cases. The neuroradiological diagnosis of GGI is important because radical surgical removal of these lesions is considered the first-line procedure. Surgery is justified by the good prognosis for patients in terms both of survival and quality of residual life, since it is curative or allows pharmacological control of epilepsy even after subtotal removal.

The Symptomatic Incompetent Cervical Intervertebral Disc

Neurosurgery ◽  
1989 ◽  
Vol 25 (2) ◽  
pp. 232-239 ◽  
Author(s):  
John Vassilouthis ◽  
Angelos Kalovithouris ◽  
Athinodoros Papandreou ◽  
Stergios Tegos
Keyword(s):  
Spinal Cord ◽  
Intervertebral Disc ◽  
Spinal Canal ◽  
Positive Contrast ◽  
Intervertebral Discs ◽  
Response To Treatment ◽  
Complete Relief ◽  
Surgical Removal ◽  
Nerve Roots ◽  
Disc Protrusion

Abstract A series of 16 patients with symptoms such as pain in the neck, occiput, shoulder and arm; numbness in the hands: and/or difficulty in walking, is described. Neurological examination of the upper extremities disclosed signs of nerve roots dysfunction in 5 patients and long tract signs in 12, whereas examination of the lower extremities disclosed long tract signs in every patient. Positive contrast cervical myelograms suggested mild posterior bulging of one or two intervertebral discs in every patient, but computed tomographic myelograms invariably demonstrated a coincident narrow cervical spinal canal, thus revealing the true compressive potential of the aforementioned mild disc protrusion on the spinal cord. All patients underwent anterior cervical microdiscectomy of the offending disc or discs, which were found to be degenerated. No case of frank rupture of the anulus was identified. Response to treatment was graded as excellent in 12 patients, who had complete relief of symptoms, and good in 4 patients, who had mild residual complaints. This study suggests that incompetence (bulging) of a cervical intervertebral disc may acquire important clinical significance in the presence of a narrow spinal canal by compressing the spinal cord and the corresponding nerve roots. Surgical removal of the diseased disc may result in restoration of neurological function.

Outcomes in treatment for primary spinal anaplastic ependymomas: a retrospective series of 20 patients

2013 ◽  
Vol 19 (1) ◽  
pp. 3-11 ◽  
Author(s):  
XiaoDong Liu ◽  
Bing Sun ◽  
QiWu Xu ◽  
XiaoMing Che ◽  
Jie Hu ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Radiation Therapy ◽  
Cervical Spinal Cord ◽  
Surgical Removal ◽  
Thoracic Spinal ◽  
Grade Ii ◽  
Preoperative Status ◽  
The Mean ◽  
Subtotal Removal

Object Little is known regarding the anaplastic variant of primary ependymomas that involve the spinal cord. The aim of this study was to evaluate the clinical characteristics and treatment outcomes of primary spinal anaplastic ependymomas (PSAEs). Methods Medical records were reviewed in 20 patients with pathologically proven PSAEs who underwent surgical treatment at the Department of Neurosurgery in Huashan Hospital between 1999 and 2008. Results This series included 7 women and 13 men between the ages of 2 and 67 years (mean 31.9 years). The mean preoperative course was 9.3 months (range 20 days to 48 months). The most common PSAE locations were the cervical and thoracic spinal cords. The most common presenting symptom was weakness, followed by numbness, bowel or bladder dysfunction, and pain. Gross-total resection (GTR) was achieved in 17 patients, and a subtotal removal was performed in 3 patients. Nine patients received radiation therapy and/or chemotherapy. The mean follow-up duration was 83.5 months. Functional assessment of the 10 patients available at the latest follow-up evaluation showed that 2 had worsened and 8 remained unchanged from their preoperative status. There were 2 local recurrences and 1 lung metastasis. Conclusions Patients with PSAEs presented with a much shorter preoperative course than patients with Grade II ependymomas in previous studies. Patients with tumors that involved the cervical spinal cord experienced a worse outcome. Surgical removal of PSAEs, with the goal of GTR, is beneficial to patients. The role of radiation therapy and chemotherapy in PSAEs remains to be determined in further studies.

Ruptured Spinal Arteriovenous Malformation

2019 ◽  
pp. 287-296
Author(s):  
Brandon D. Liebelt ◽  
Michaela H. Lee ◽  
Peter Nakaji ◽  
Robert F. Spetzler
Keyword(s):  
Spinal Cord ◽  
Neurological Deficit ◽  
Arteriovenous Malformations ◽  
Abrupt Onset ◽  
Sudden Onset ◽  
Spinal Arteriovenous Malformation ◽  
History Of ◽  
Severe Back Pain ◽  
Spinal Arteriovenous Malformations ◽  
Microsurgical Resection

Abstract: Ruptured spinal arteriovenous malformations are a rare cause of spinal cord injury. They should be considered especially in the differential diagnosis of younger patients with sudden onset of both severe back pain and neurological deficit. They may present with abrupt onset of hemorrhage, spinal edema and progressive myelopathy, and sudden thrombosis. They may occur in any part of the spinal cord anatomically. The pathophysiology and natural history of these lesions are poorly understood. When feasible, microsurgical resection is the most effective treatment for prevention of further hemorrhage or neurological deficit. In distinction to cerebral arteriovenous malformations, spinal cord malformations can often be treated effectively by pruning the extramedullary vasculature without removing the entire lesion.

Lipomas of the spinal cord and cauda equina

1971 ◽  
Vol 34 (3) ◽  
pp. 349-354 ◽  
Author(s):  
Harry M. Rogers ◽  
Don M. Long ◽  
Shelley N. Chou ◽  
Lyle A. French
Keyword(s):  
Spinal Cord ◽  
Congenital Anomalies ◽  
Age Of Onset ◽  
Cauda Equina ◽  
Congenital Defects ◽  
Review Of The Literature ◽  
Content Type ◽  
X Ray ◽  
High Incidence ◽  
Subtotal Removal

✓ This report presents 18 cases of lipoma of the spinal cord or cauda equina, four of which were unassociated with congenital anomalies of the spine and 14 with such anomalies. Review of the literature shows that unassociated cases are rare, with only 100 cases reported, while those associated with congenital anomalies are more common. The patients ranged in age from 2 months to 5 years. Fourteen patients had external evidence of an abnormality in the form of a mass or dimple over the vertebral column. Plain x-ray films showed evidence of an intraspinal lesion in all cases except one. The treatment was surgical in all cases, with nine good results, eight satisfactory, and one unsatisfactory. The exact pathogenesis of spinal cord lipomas is unclear, although the high incidence of associated congenital defects, age of onset, and location of the tumors suggest a developmental origin. The tumors occupy a juxtamedullary-subpial location and are composed of firm, lobulated adult fat. Early surgery consisting of generous laminectomy, incision of the pia, and subtotal removal of the tumor is felt to be the treatment of choice.

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