当前位置： SCI文献检索 > SPINE期刊下所有文献 > Spontaneous hemorrhage of a spinal ependymoma: a rare cause of acute cauda equina syndrome: a case report.

Spontaneous hemorrhage of a spinal ependymoma: a rare cause of acute cauda equina syndrome: a case report.

Abstract：

STUDY DESIGN:An interesting case of spontaneous bleeding from an ependymoma of the filum terminale is presented. OBJECTIVES:To document a rare case of rapid neurologic deterioration as a consequence of spinal tumoral hemorrhage and to highlight important issues regarding tumor histologic subtype and the impact of anticoagulation that have emerged from an illuminating review of the literature. SUMMARY OF BACKGROUND DATA:To our knowledge, there have been only 8 reported cases of hemorrhage from an ependymoma of the filum terminale or conus medullaris causing acute cauda equina syndrome. Bleeding is described in the pathology texts as being a consequence of the vascular architecture of the myxopapillary subtype and so postulated to be more common in this group. Anticoagulation is recognized to increase the frequency of tumoral bleeding, but no studies report its effect of severity of clinical presentation. METHODS:We report the case of a 57-year-old woman who developed nontraumatic acute cauda equina syndrome, including sphincter compromise. She underwent a lumbosacral laminectomy for evacuation of a hematoma, at which stage a filum terminale ependymoma was excised. Histopathologic analysis demonstrated it to be of a nonmyxopapillary subtype. RESULTS:The patient demonstrated gradual improvement of the neurologic deficit. At 12-month follow-up, her saddle area sensory deficit has resolved, her right lower limb is much stronger allowing her to walk long distances, and she is successfully performing intermittent self-catheterization of her bladder. CONCLUSIONS:The possibility of an underlying tumor should always be borne in mind so that adequate preoperative planning can be undertaken. The presence of the myxopapillary subtype should not prevent a clinician from excluding other reasons for hemorrhage, and counseling when reinstituting anticoagulation must include warning against a worse prognosis from any future hemorrhage.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Tait MJ,Chelvarajah R,Garvan N,Bavetta S

doi

10.1097/01.brs.0000143663.27275.7f

keywords:

subject

Has Abstract

pub_date

2004-11-01 00:00:00

pages

E502-5

issue

eissn

0362-2436

issn

1528-1159

pii

00007632-200411010-00029

journal_volume

pub_type

杂志文章,评审

在线工具

Spontaneous hemorrhage of a spinal ependymoma: a rare cause of acute cauda equina syndrome: a case report.