Surgical resection of subependymoma of the cervical spinal cord

2014 ◽  
Vol 37 (v2supplement) ◽  
pp. Video3 ◽  
Author(s):  
Lee A. Tan ◽  
Manish K. Kasliwal ◽  
Nakhle Mhanna ◽  
Ricardo B. V. Fontes ◽  
Vincent C. Traynelis
Keyword(s):  
Spinal Cord ◽  
Rare Case ◽  
Cervical Spinal Cord ◽  
Conus Medullaris ◽  
Resonance Imaging ◽  
Spinal Cord Tumors ◽  
Gadolinium Enhancement ◽  
Cervicothoracic Junction ◽  
Total Resection ◽  
Thoracic Cord

Subependymomas can rarely occur in the spinal cord, and account for about 2% of symptomatic spinal cord tumors. It most often occurs in the cervical spinal cord, followed by cervicothoracic junction, thoracic cord and conus medullaris. It often has an eccentric location in the spinal cord and lacks gadolinium enhancement on magnetic resonance imaging. We present a rare case of symptomatic subependymoma of the cervical spinal cord, which underwent successful gross total resection. Surgical pearls and nuances are discussed to help surgeons to avoid potential complications.The video can be found here: http://youtu.be/Rsm9KxZX7Yo.

scholarly journals Intradural Extramedullary Spinal Sarcoidosis Mimicking Meningioma

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Sho Ishiwata ◽  
Yoichi Iizuka ◽  
Tokue Mieda ◽  
Junko Hirato ◽  
Hiromi Koshi ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Rare Entity ◽  
Resonance Imaging ◽  
Spinal Cord Tumors ◽  
Total Resection ◽  
Case Presentation ◽  
Dural Tail Sign ◽  
Dural Tail ◽  
Intradural Extramedullary ◽  
Magnetic Resonance Imaging Mri

Background. Spinal sarcoidosis is a rare subgroup of neurosarcoidosis. Although most sarcoid lesions develop in the intramedullary compartment, intradural extramedullary (IDEM) spinal sarcoidosis is an extremely rare entity. Case Presentation. We herein report a case of IDEM spinal sarcoidosis mimicking a meningioma. A 32-year-old man presented to the hospital with clumsy hands and was unable to walk without assistance. Magnetic resonance imaging (MRI) of the cervical spine revealed a dural tail sign that is common in meningiomas. The patient underwent gross total resection. The pathological findings consisted with a sarcoid leision of the spinal cord. The patient’s myelopathy recovered after surgery. Conclusions. Physicians should be alert for the possibility of IDEM sarcoidosis mimicking a meningioma in the differential diagnosis of IDEM spinal cord tumors.

scholarly journals Cervical Intramedullary Schwannoma with Syrinx: Case Report and Review of the Literature

2017 ◽  
Vol 07 (03) ◽  
pp. 239-248
Author(s):  
Abdulaziz AlQarni ◽  
A. AlArifi ◽  
Ali Alassiri ◽  
Amjed Kouli ◽  
M. Abbas
Keyword(s):  
Spinal Cord ◽  
Cervical Spinal Cord ◽  
Lower Limbs ◽  
Nerve Sheath Tumor ◽  
Resonance Imaging ◽  
Spinal Cord Tumors ◽  
Nerve Sheath ◽  
Spindle Cells ◽  
The Right ◽  
Intramedullary Schwannoma

AbstractSchwannoma is a nerve sheath tumor originating from the Schwann cell. It is benign in nature and it arises from anywhere where Schwann cells can be found. It is rarely found in the parenchyma of the spinal cord. Intramedullary schwannomas (or neurilemmomas) without evidence of neurofibromatosis are rare spinal cord tumors. Intramedullary schwannoma was first reported in 1932 by Penfield. Our patient presented with neck pain, gradually worsening, weakness in the right upper and lower limbs, numbness in both shoulders, and a decrease in the grasping strength of both hands over a 4-year period. A magnetic resonance imaging of the spine showed a heterogeneously enhancing mass in the cervical spinal cord extending from the C2 to T1 levels with associated hemorrhagic changes. Histologically, the tumor was found to be composed of bland spindle cells with blunt-ended and sometimes wavy nuclei admixed with hyalinized vasculature. Surrounding reactive spinal cord parenchyma with frequent Rosenthal fibers was also observed. Focal Verocay bodies were evident, and with immunohistochemistry, there was diffuse and strong positivity for S100, which is confirmatory for the diagnosis of schwannoma. We report a case of cervical intramedullary schwannoma presented with syringobulbia in a young adult.

Central neurocytomas of the cervical spinal cord

1994 ◽  
Vol 81 (2) ◽  
pp. 288-293 ◽  
Author(s):  
Stephen B. Tatter ◽  
Lawrence F. Borges ◽  
David N. Louis
Keyword(s):  
Spinal Cord ◽  
Cervical Spinal Cord ◽  
Correct Diagnosis ◽  
Central Neurocytoma ◽  
Neurological Deficits ◽  
Resonance Imaging ◽  
Spinal Cord Tumors ◽  
Intramedullary Spinal Cord ◽  
Content Type ◽  
Fine Print

✓ Central neurocytoma is a neuronal neoplasm that occurs supratentorially in the lateral or third ventricles. The authors report the clinical, neuroradiological, and neuropathological features of two neurocytomas arising in the spinal cord of two men, aged 65 and 49 years. The patients presented with progressive neurological deficits referable to the cervical spinal cord. Magnetic resonance imaging revealed isodense intramedullary spinal cord tumors at the C3–4 level. Both tumors were initially misdiagnosed as gliomas. In Case 1 the correct diagnosis was made after electron microscopy revealed neuronal features. Immunostaining in Case 2 revealed that tumor cells were positive for synaptophysin and negative for glial fibrillary acidic protein, strongly indicating a neuronal tumor. It is suggested that this spinal cord neoplasm be included under the designation “central neurocytoma.”

Multisession CyberKnife Radiosurgery for Intramedullary Spinal Cord Arteriovenous Malformations

Neurosurgery ◽  
2006 ◽  
Vol 58 (6) ◽  
pp. 1081-1089 ◽  
Author(s):  
John Sinclair ◽  
Steven D. Chang ◽  
Iris C. Gibbs ◽  
John R. Adler
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Arteriovenous Malformations ◽  
Conus Medullaris ◽  
Spinal Angiography ◽  
Resonance Imaging ◽  
Intramedullary Spinal Cord ◽  
Cyberknife Radiosurgery

Abstract OBJECTIVE: Intramedullary spinal cord arteriovenous malformations (AVMs) have an unfavorable natural history that characteristically involves myelopathy secondary to progressive ischemia and/or recurrent hemorrhage. Although some lesions can be managed successfully with embolization and surgery, AVM size, location, and angioarchitecture precludes treatment in many circumstances. Given the poor outlook for such patients, and building on the successful experience with radiosurgical ablation of cerebral AVMs, our group at Stanford University has used CyberKnife (Accuray, Inc., Sunnyvale, CA) stereotactic radiosurgery (SRS) to treat selected spinal cord AVMs since 1997. In this article, we retrospectively analyze our preliminary experience with this technique. METHODS: Fifteen patients with intramedullary spinal cord AVMs (nine cervical, three thoracic, and three conus medullaris) were treated by image-guided SRS between 1997 and 2005. SRS was delivered in two to five sessions with an average marginal dose of 20.5 Gy. The biologically effective dose used in individual patients was escalated gradually over the course of this study. Clinical and magnetic resonance imaging follow-up were carried out annually, and spinal angiography was repeated at 3 years. RESULTS: After a mean follow-up period of 27.9 months (range, 3–59 mo), six of the seven patients who were more than 3 years from SRS had significant reductions in AVM volumes on interim magnetic resonance imaging examinations. In four of the five patients who underwent postoperative spinal angiography, persistent AVM was confirmed, albeit reduced in size. One patient demonstrated complete angiographic obliteration of a conus medullaris AVM 26 months after radiosurgery. There was no evidence of further hemorrhage after CyberKnife treatment or neurological deterioration attributable to SRS. CONCLUSION: This description of CyberKnife radiosurgical ablation demonstrates its feasibility and apparent safety for selected intramedullary spinal cord AVMs. Additional experience is necessary to ascertain the optimal radiosurgical dose and ultimate efficacy of this technique.

scholarly journals Feasibility of a novel diagnostic chart of intramedullary spinal cord tumors in magnetic resonance imaging

Spinal Cord ◽  
2014 ◽  
Vol 52 (10) ◽  
pp. 769-773 ◽  
Author(s):  
H Arima ◽  
T Hasegawa ◽  
D Togawa ◽  
Y Yamato ◽  
S Kobayashi ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Spinal Cord Tumors ◽  
Intramedullary Spinal Cord

Spine-shortening vertebral osteotomy in a patient with tethered cord syndrome and a vertebral fracture

2008 ◽  
Vol 9 (1) ◽  
pp. 62-66 ◽  
Author(s):  
Haruo Kanno ◽  
Toshimi Aizawa ◽  
Hiroshi Ozawa ◽  
Takeshi Hoshikawa ◽  
Eiji Itoi ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Vertebral Fracture ◽  
Rare Case ◽  
Tethered Cord ◽  
Conus Medullaris ◽  
Tethered Cord Syndrome ◽  
Bone Union ◽  
Tethered Spinal Cord ◽  
Fracture Fragment ◽  
Loss Of Correction

The authors report a rare case of tethered cord syndrome with low-placed conus medullaris complicated by a vertebral fracture that was successfully treated by a spine-shortening vertebral osteotomy. The patient was a 57-year-old woman whose neurological condition worsened after a T-12 vertebral fracture because a fracture fragment and the associated local kyphotic deformity directly compressed the tethered spinal cord. An osteotomy of the T-12 vertebra was performed in order to correct the kyphosis, remove the fracture fragment, and reduce the tension on the spinal cord. Postoperative radiographs showed the spine to be shortened by 22 mm, and the kyphosis between T-11 and L-1 improved from 23° to 0°. Two years after the surgery, the patient's neurological symptoms were resolved. The bone union was complete with no loss of correction.

scholarly journals A Prognostic Factor for Prolonged Mechanical Ventilator-Dependent Respiratory Failure after Cervical Spinal Cord Injury : Maximal Canal Compromise on Magnetic Resonance Imaging

2021 ◽  
Vol 64 (5) ◽  
pp. 791-798
Author(s):  
Subum Lee ◽  
Sung Woo Roh ◽  
Sang Ryong Jeon ◽  
Jin Hoon Park ◽  
Kyoung-Tae Kim ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Respiratory Failure ◽  
Hospital Stay ◽  
Cervical Spinal Cord ◽  
Mechanical Ventilator ◽  
Inclusion Criteria ◽  
Resonance Imaging ◽  
Cord Injury

Objective : The period of mechanical ventilator (MV)-dependent respiratory failure after cervical spinal cord injury (CSCI) varies from patient to patient. This study aimed to identify predictors of MV at hospital discharge (MVDC) due to prolonged respiratory failure among patients with MV after CSCI.Methods : Two hundred forty-three patients with CSCI were admitted to our institution between May 2006 and April 2018. Their medical records and radiographic data were retrospectively reviewed. Level and completeness of injury were defined according to the American Spinal Injury Association (ASIA) standards. Respiratory failure was defined as the requirement for definitive airway and assistance of MV. We also evaluated magnetic resonance imaging characteristics of the cervical spine. These characteristics included : maximum canal compromise (MCC); intramedullary hematoma or cord transection; and integrity of the disco-ligamentous complex for assessment of the Subaxial Cervical Spine Injury Classification (SLIC) scoring. The inclusion criteria were patients with CSCI who underwent decompression surgery within 48 hours after trauma with respiratory failure during hospital stay. Patients with Glasgow coma scale 12 or lower, major fatal trauma of vital organs, or stroke caused by vertebral artery injury were excluded from the study.Results : Out of 243 patients with CSCI, 30 required MV during their hospital stay, and 27 met the inclusion criteria. Among them, 48.1% (13/27) of patients had MVDC with greater than 30 days MV or death caused by aspiration pneumonia. In total, 51.9% (14/27) of patients could be weaned from MV during 30 days or less of hospital stay (MV days : MVDC 38.23±20.79 vs. MV weaning, 13.57±8.40; p<0.001). Vital signs at hospital arrival, smoking, the American Society of Anesthesiologists classification, Associated injury with Injury Severity Score, SLIC score, and length of cord edema did not differ between the MVDC and MV weaning groups. The ASIA impairment scale, level of injury within C3 to C6, and MCC significantly affected MVDC. The MCC significantly correlated with MVDC, and the optimal cutoff value was 51.40%, with 76.9% sensitivity and 78.6% specificity. In multivariate logistic regression analysis, MCC >51.4% was a significant risk factor for MVDC (odds ratio, 7.574; p=0.039).Conclusion : As a method of predicting which patients would be able to undergo weaning from MV early, the MCC is a valid factor. If the MCC exceeds 51.4%, prognosis of respiratory function becomes poor and the probability of MVDC is increased.

scholarly journals Thoracolumbar pilomyxoid astrocytoma concomitant with spinal scoliosis: A case report and literature review

2019 ◽  
Vol 10 ◽  
pp. 235
Author(s):  
Alireza Tabibkhooei ◽  
Alireza Sadeghipour ◽  
Arash Fattahi
Keyword(s):  
Spastic Paraparesis ◽  
Conus Medullaris ◽  
Cervicothoracic Junction ◽  
Decompressive Laminectomy ◽  
Pilomyxoid Astrocytoma ◽  
Pilocytic Astrocytomas ◽  
Thoracic Cord ◽  
Early Performance ◽  
Symptom Progression ◽  
Tumor Debulking

Background: Pilomyxoid astrocytoma (PMA) is a variant of pilocytic astrocytomas but exhibits more aggressive behavior. Further, it is more prevalent in the hypothalamic/chiasmatic regions and is only rarely encountered in the thoracic spine. Case Description: A 9-year-old male presented with severe spastic paraparesis (motor/sensory) attributed to a thoracic cord PMA and scoliosis. The magnetic resonance (MR) showed an intraaxial ill-defined expansile lesion with heterogeneous enhancement extending from the cervicothoracic junction to conus medullaris. A multilevel decompressive laminectomy was performed with restricted tumor debulking; an expansile duraplasty was also effected. Two years later, the patient has moderately improved and has not shown any symptom progression. Conclusion: We recommend the early performance of a thoracic MR in children with idiopathic scoliosis presenting with the onset of a significant spastic paraparesis.

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