[Cauda equina neurinoma associated with intracranial hypertension--case report]

A case of cauda equina neurinoma associated with intracranial hypertension is reported. A 59-year-old female with a history of disturbed orientation was admitted. A neurological examination upon admission revealed the disorientation and gait disturbance. Superficial sensation under L3 was impaired. A computed tomographic(CT) scan presented the enlargement of ventricles and the slightly poor description of cerebral sulci. Since the patient had a high fever up to 40.1 C, meningitis was suspected. Cerebrospinal fluid revealed that cell count was only 2/3, while the protein concentration was markedly elevated (389mg/dl). Froin reaction was extremely positive and fibrin was observed. Based upon these findings, the spinal tumor was considered. Plain lumber film showed the posterior scalloping of the L5 and S1 vertebral bodies. Gd-DTPA enhanced MRI showed a high signal intensity area at the cauda equina. Diagnosed as a cauda equina tumor, the total resection of the tumor was performed via laminectomy of L3-S1. The tumor was involved with nerve filaments at the cauda equina. The pathological diagnosis was neurinoma. After the operation, her symptoms improved and a CT scan revealed the reduction of the ventricular size. However, the protein concentration of cerebrospinal fluid did not normalized.