Nondural-based lumbar clear cell meningioma

1996 ◽  
Vol 84 (2) ◽  
pp. 264-266 ◽  
Author(s):  
Robert N. N. Holtzman ◽  
Susan C. Jormark
Keyword(s):  
Clear Cell ◽  
Cauda Equina ◽  
Complete Removal ◽  
Leg Pain ◽  
Content Type ◽  
Single Root ◽  
Clear Cell Meningioma ◽  
Extensor Hallucis Longus ◽  
The Right ◽  
Immunohistochemical Analyses

✓ This 32-year-old man had noticed right leg pain for 4 years and developed classic right sciatica after heavy lifting, followed by episodes of buckling of both legs 1 month prior to admission. His medical history included congenital left abducens palsy. Examination revealed a right Lasègue's sign and Fajersztajn's sign with mild weakness of the right extensor hallucis longus. Magnetic resonance imaging revealed a 1.5 × 2.0—cm enhancing intradural lesion at the L3–4 level. Following laminectomy of L-3 and L-4 and intradural exposure, the tumor was found to be draped loosely by the roots of the cauda equina and attached to a single root without any adherence to dura. Transection of the adherent fascicles and typical microdissection of arachnoidal filaments permitted its complete removal without violation of the capsule, allowing the preservation of a large fascicle. The patient's recovery was uneventful. Postoperatively, a mild right lateral foot hypalgesia and diminution of the right ankle jerk implicated the S-1 root. Histological and immunohistochemical analyses diagnosed the specimen as a clear cell meningioma.

scholarly journals Resection of a Dumbbell Skull Base Meningioma by a Combined Two-Staged Retrosigmoid and Transzygomatic Transcavernous Approach

2018 ◽  
Vol 80 (S 03) ◽  
pp. S298-S299 ◽  
Author(s):  
Álvaro Campero ◽  
Leoncio Tovar ◽  
Pablo Ajler
Keyword(s):  
Posterior Fossa ◽  
Cavernous Sinus ◽  
Neurological Deficit ◽  
Clear Cell ◽  
Surgical Complication ◽  
Complete Removal ◽  
Clear Cell Meningioma ◽  
Skull Base Meningioma ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

This case describes a 32-year-old male with 2 months of headache accompanied with slight right-hand hemiparesis. During a physical examination, he was also detected left facial hypoesthesia. An enhanced magnetic resonance imaging (MRI) showed a large size lesion on the region of the left cerebellopontine angle, with large displacement of the brainstem and cerebellum. The tumor extended to the cavum of Meckel, displacing and pushing the left cavernous sinus upward. After analyzing the anatomical characteristics of the tumor, surgery was decided in two steps. Since the symptoms were mostly produced by the tumor part located in the posterior fossa, a decision was made to first resect that part of the tumor. With the patient in a semisitting position, we performed a left retrosigmoid craniotomy, exposing the transverse and sigmoid sinus edges. Using microsurgical technique, and ultrasonic aspirator, the complete removal of the lesion located in the posterior fossa was achieved. The patient presented a very good postoperative period, without a new neurological deficit. A month after the surgery, the patient no longer suffered from headaches or hemiparesis, but continued the left facial hypoesthesia. The pathology reported clear cell meningioma. Another month later, a transcygomatic approach plus peeling of the cavernous sinus was performed with the patient in the supine position and head rotated to the right side. Spinal drainage was previously placed. The total resection of the tumor was achieved without any surgical complication. The patient presented an excellent postoperative condition without new neurological deficit. The pathologist confirmed the diagnosis of clear cell meningioma.The link to the Video can be found at: https://youtu.be/SmRy5HiJYJI.

Lobular capillary hemangioma of the cauda equina

1999 ◽  
Vol 90 (2) ◽  
pp. 239-241 ◽  
Author(s):  
Robert N. N. Holtzman ◽  
Paul M. Brisson ◽  
Richard E. Pearl ◽  
Michael L. Gruber
Keyword(s):  
Nerve Root ◽  
Cauda Equina ◽  
Complete Removal ◽  
Capillary Hemangioma ◽  
Lobular Capillary Hemangioma ◽  
Content Type ◽  
Tendon Reflex ◽  
History Of ◽  
Normal Strength ◽  
The Right

✓ This 56-year-old woman presented with a 1-year history of low-back pain, sciatica, and paresthesias in the right S-1 dermatome. On examination the patient was shown to have a right-sided Lasègue's sign, normal strength, hypalgesia in the right S-1 dermatome, and a slight diminution of the right Achilles tendon reflex. Magnetic resonance imaging revealed a 2-cm intradural enhancing lesion at the level of the L-4 vertebra. Laminectomy of L3–L5 vertebrae was performed, and intradural exploration disclosed a blueberry-appearing tumor that was surrounded by an intense arachnoiditis and attached to the right S-1 nerve root. A cystic collection of cerebrospinal fluid was seen caudal to the tumor. Complete removal required transection of the adherent nerve root fascicles. Histological analyses indicate that the lesion was a lobular capillary hemangioma, which, to the authors' knowledge, appears to be one of the first recorded examples of such a case.

Dermoid tumors of the spinal cord

1970 ◽  
Vol 33 (6) ◽  
pp. 676-681 ◽  
Author(s):  
Ian C. Bailey
Keyword(s):  
Spinal Cord ◽  
Low Back Pain ◽  
Back Pain ◽  
Cauda Equina ◽  
Complete Removal ◽  
Cord Compression ◽  
Conus Medullaris ◽  
Low Back ◽  
Content Type ◽  
Fine Print

✓ This is an analysis of 10 cases of dermoid tumor occurring in the spinal canal (8 lumbar and 2 thoracic). Low-back pain was the commonest presenting symptom, especially if the tumor was adherent to the conus medullaris. Other complaints included urinary dysfunction and motor and sensory disturbances of the legs. Clinical and radiological evidence of spina bifida was found in about half of the cases and suggested the diagnosis of a developmental type of tumor when patients presented with progressive spinal cord compression. At operation, the tumors were often found embedded in the conus medullaris or firmly adherent to the cauda equina, thus precluding complete removal. Evacuation of the cystic contents, however, gave lasting relief of the low-back pain and did not cause any deterioration in neurological function. In a follow-up study, ranging from 1 to 15 years, virtually no improvement in the neurological signs was observed. On the other hand, only one case has deteriorated due to recurrence of tumor growth.

Acute cauda equina syndrome from a ruptured aneurysm in the sacral canal

1992 ◽  
Vol 77 (6) ◽  
pp. 945-948 ◽  
Author(s):  
Richard H. Schmidt ◽  
M. Sean Grady ◽  
Wendy Cohen ◽  
Sanford Wright ◽  
H. Richard Winn
Keyword(s):  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Signs And Symptoms ◽  
Vascular Supply ◽  
Ruptured Aneurysm ◽  
Collateral Flow ◽  
Content Type ◽  
Internal Iliac ◽  
The Right ◽  
Sacral Canal

✓ The case is presented of a young woman with acute cauda equina syndrome from a ruptured aneurysm in the sacral canal. The lesion was associated with pathological enlargement of the lateral sacral arteries bilaterally, which presumably occurred to provide cross-pelvic collateral flow in response to the diversion of the right internal iliac artery for renal transplantation. The patient presented with signs and symptoms of spontaneous spinal epidural hemorrhage. The radiographic features of this lesion are described. In addition to angiography and partial embolization of the vascular supply, contrast-enhanced high-resolution computerized tomography was essential in the diagnosis and treatment of this unique aneurysm.

Nondura-based clear cell meningioma of the cauda equina in an adult

2013 ◽  
Vol 18 (5) ◽  
pp. 861-865 ◽  
Author(s):  
Yoshiomi Kobayashi ◽  
Masaya Nakamura ◽  
Osahiko Tsuji ◽  
Akio Iwanami ◽  
Ken Ishii ◽  
...  
Keyword(s):  
Clear Cell ◽  
Cauda Equina ◽  
Clear Cell Meningioma

Symptomatic cerebellar metastasis and late local recurrence of a cauda equina paraganglioma

1995 ◽  
Vol 83 (1) ◽  
pp. 166-169 ◽  
Author(s):  
Kevin N. Strommer ◽  
Sebastian Brandner ◽  
Ali C. Sarioglu ◽  
Ulrich Sure ◽  
Yasuhiro Yonekawa
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cystic Lesion ◽  
Cauda Equina ◽  
Complete Removal ◽  
Pathological Examination ◽  
Resonance Imaging ◽  
Content Type ◽  
Truncal Ataxia ◽  
Cerebellar Metastasis ◽  
Fine Print

✓ This case report contains a description of a 61-year-old patient who presented with a progressive truncal ataxia 22 years after complete removal of a small paraganglioma of the cauda equina. Magnetic resonance imaging of the neuraxis revealed a large cystic lesion in the cerebellar midline, three small cortical-to-subcortical nodular tumors in the posterior fossa, and local recurrences of the paraganglioma of the cauda equina. Pathological examination showed the cerebellar midline lesion to be a paraganglioma, most likely a metastasis from the cauda equina localization.

scholarly journals Unilateral Cauda Equina Syndrome Due to Cancer Metastasis Diagnosed with Electromyography: A Case Report

Healthcare ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1370
Author(s):  
Chan-Hee Park ◽  
Eunhee Park ◽  
Tae-Du Jung
Keyword(s):  
Lumbar Spine ◽  
Cauda Equina Syndrome ◽  
Cancer Metastasis ◽  
Proper Time ◽  
Cauda Equina ◽  
B Cell Lymphoma ◽  
Leg Pain ◽  
Muscle Membrane ◽  
The Right ◽  
Hands And Feet

Background: Typical cauda equina syndrome (CES) presents as low back pain, bilateral leg pain with motor and sensory deficits, genitourinary dysfunction, saddle anesthesia and fecal incontinence. In addition, it is a neurosurgical emergency, which is essential to diagnose as soon as possible, and needs prompt intervention. However, unilateral CES is rare. Here, we report a unique case of a patient who had unilateral symptoms of CES due to cancer metastasis and was diagnosed through electromyography. Methods: A 71-year-old man with diffuse large B cell lymphoma (DLBCL) suffered from severe pain, motor weakness in the right lower limb and urinary incontinence, and hemi-saddle anesthesia. It was easy to be confused with lumbar radiculopathy due to the unilateral symptoms. Lumbar spine magnetic resonance imaging (MRI) showed suspected multifocal bone metastasis in the TL spine, including T11-L5, the bilateral sacrum and iliac bones, and suspected epidural metastasis at L4/5, L5/S1 and the sacrum. PET CT conducted after the third R-CHOP showed residual hypermetabolic lesions in L5, the sacrum, and the right presacral area. Results: Nerve conduction studies (NCS) revealed peripheral neuropathy in both hands and feet. Electromyography (EMG) presented abnormal results indicating development of muscle membrane instability following neural injury, not only on the right symptomatic side, but also on the other side which was considered intact. Overall, he was diagnosed with cauda equina syndrome caused by DLBCL metastasis, and referred to neurosurgical department. Conclusions: Early diagnosis of unilateral CES may go unnoticed due to its unilateral symptoms. Failure to perform the intervention at the proper time can impede recovery and leave permanent complications. Therefore, physicians need to know not only the typical CES, but also the clinical features of atypical CES when encountering a patient, and further evaluation such as electrodiagnostic study or lumbar spine MRI have to be considered.

scholarly journals Resolution of cauda equina syndrome after surgical extraction of lumbar intrathecal bullet

2020 ◽  
Vol 11 ◽  
pp. 214
Author(s):  
Zaid Aljuboori ◽  
Emily Sieg
Keyword(s):  
Lower Extremity ◽  
Urinary Retention ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Spinal Column ◽  
Neurological Damage ◽  
Burning Pain ◽  
Extensor Hallucis Longus ◽  
Surgical Extraction ◽  
The Right

Background: Gunshot wound (GSW) injuries to the spinal column are correlated with potentially severe neurological damage. Here, we describe a GSW to the thoracolumbar junction (e.g., T12/L1 level) which resulted in a cauda equina syndrome that resolved once the bullet was removed. Case Description: A 29-year-old male presented with a T12-L1 GSW; the bullet traversed the right chest and liver, entered the spinal canal at T12, and then settled at L1. He experienced excruciating burning pain in the right lower extremity/perineum and had urinary retention. On neurological examination, he exhibited severe weakness of the right iliopsoas/quadriceps (2/5) and extensor hallucis longus (1/5) which had decreased sensation in the right lower extremity in all dermatomes and urinary retention. The myelogram showed the bullet lodged intrathecally at L1; it compressed the cauda equina. Immediately after, the bullet was extracted and at 8 weeks follow-up, the patient’s right-sided motor function normalized, the sensory findings improved, and the sphincteric dysfunction resolved; the only residual deficit was minimal residual numbness in the L2-L5 distributions. Conclusion: Twenty percent of penetrating spinal column injuries are attributed to GSW s. The location of these injuries best determines the neurological damage and degree of recovery. Since patients with incomplete cauda equina syndromes have favorable prognoses, removal of bullets involving the T12-S1 levels may prove beneficial.

Clear Cell Meningioma: Case Report and Review of the Literature

2005 ◽  
Vol 8 (3) ◽  
pp. 386-390 ◽  
Author(s):  
Angelica Oviedo ◽  
Dachling Pang ◽  
John Zovickian ◽  
Matthew Smith
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Cerebellopontine Angle ◽  
Clear Cell ◽  
Cauda Equina ◽  
Review Of The Literature ◽  
Clear Cell Meningioma ◽  
Clear Cell Ependymoma ◽  
Microcystic Meningioma ◽  
Histology And Immunohistochemistry

Clear cell meningioma (CCM) is a rare variant of meningioma. Only 17 cases have been previously reported in children. Although it has bland cytologic features, it has a higher rate of recurrence than does conventional meningioma. This variant has been reported in sites such as spinal/intradural (lumbar and thoracic), cerebellopontine angle, and supratentorial. The differential diagnosis of CCM includes microcystic meningioma, hemangioblastoma, and clear cell ependymoma. The characteristic histology and immunohistochemistry leads to the diagnosis. We present a case of a 7-year-old boy with a CCM of the cauda equina and a review of pediatric CCM.

Intraspinal familial clear cell meningioma in a mother and child

2000 ◽  
Vol 93 (2) ◽  
pp. 317-321 ◽  
Author(s):  
Jason A. Heth ◽  
Patricia Kirby ◽  
Arnold H. Menezes
Keyword(s):  
Clear Cell ◽  
Content Type ◽  
Intraspinal Tumor ◽  
Clear Cell Meningioma ◽  
Mother And Child ◽  
Fine Print

✓ The authors present a case of familial clear cell meningioma in which the proband is a child with an intraspinal tumor. The clear cell meningioma variant has recently been studied. The literature regarding clear cell meningioma is reviewed.

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