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Cervicobulbar intramedullary lipoma.

Sandeep Mohindra1, Sunil Kumar Gupta

  • 1Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India. sandeepmohindra@gmail.com

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This study highlights a rare intramedullary spinal lipoma with intracranial extension in an adult. Surgical removal effectively resolved symptoms of high cord compression and myelopathy.

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Area of Science:

  • Neuroscience
  • Neurosurgery
  • Radiology

Background:

  • Spinal lipomas are rare, particularly those not associated with spinal dysraphism.
  • Large medullary lipomas with intracranial extension are infrequently documented.
  • Intradural lipomas are typically subpial rather than truly intramedullary.

Observation:

  • A rare case of an adult male with a medullary lipoma extending into the posterior fossa is presented.
  • The patient exhibited spastic quadriparesis, indicative of high cord myelopathy.
  • Radiological imaging confirmed a dorsally placed intramedullary lipoma with intracranial extension.

Findings:

  • Surgical excision of the medullary lipoma resulted in a satisfactory resolution of the patient's symptoms.
  • Magnetic resonance imaging (MRI) is the preferred modality for diagnosis and follow-up of such lesions.

Implications:

  • Medullary lipomas can manifest with symptoms of severe high cord compression and myelopathy.
  • Even incomplete surgical removal (subtotal excision) and decompression can lead to long-term symptom-free survival.
  • Awareness of this rare entity and its presentation is crucial for clinicians.