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Acute bleeding into a filum terminale ependymoma.
E Herb1, R Schwachenwald, G Nowak
1Department of Neurosurgery, Medical University of Lübeck, West Germany.
Neurosurgical Review
|January 1, 1990
Summary
A rare spinal ependymoma caused acute cauda equina syndrome in a male patient. Emergency surgery successfully removed the bleeding tumor, highlighting the importance of timely diagnosis for this uncommon condition.
Area of Science:
- Neurosurgery
- Oncology
- Radiology
Background:
- Spinal ependymomas are rare neurosurgical tumors, with tumors of the filum terminale being particularly uncommon.
- Acute cauda equina compression syndrome is a rare presentation for spinal tumors.
Observation:
- A 63-year-old male presented with a year of sciatica, progressing to acute cauda equina compression syndrome.
- Initial CT scans were negative, but a lumbar myelogram revealed a complete block at L2/3.
- Emergency surgery identified and removed a massive hemorrhage within a filum terminale ependymoma.
Findings:
- Hemorrhage into spinal ependymomas can lead to acute neurological deficits.
- Mechanical and histopathological factors may contribute to acute tumor bleeding.
- This case highlights the diagnostic challenges and rarity of ependymomas presenting as acute cauda equina syndrome.
Implications:
- Prompt surgical intervention is crucial for managing acute cauda equina compression syndrome.
- Advanced imaging like myelography may be necessary when initial CT scans are inconclusive.
- Understanding the factors leading to tumor hemorrhage can improve diagnostic and treatment strategies for spinal ependymomas.