[Case of intracranial and spinal dissemination of primary spinal glioma]

A case of glioblastoma multiforme of spinal cord followed by intracranial dissemination was reported. A 20-year-old man was admitted on Sep. 22, 1981, with motor disturbance of both legs and loss of urinary control. Neurological examination showed spastic paraplegia with bilateral Babinski signs. Abdominal and cremaster reflexes were absent. There was no abnormalities in cranial nerves and upper limbs. Cerebral CT was normal at that time. Myelography showed complete block at the level of 8th thoracic vertebra. Spinal angiography revealed abnormal vascularity at the level of Th7 fed via anterior spinal artery. Intramedullary tumor was partially removed through 5th-8th thoracic laminectomy. Total 5600 rads of irradiation was administered after the operation. The postoperative course was deteriorating. Two months after the operation paresis of both upper extremities had been developed. State of consciousness had been disturbed due to increased intracranial pressure which was subsided for a time while by ventriculoperitoneal shunt. Repeated CT showed high density spots scattered in basal cisterns spreading to all ventricular systems. He expired Feb. 21, 1982. Autopsy revealed that the whole spinal cord was covered by tumor tissue. Basal cisterns were filled with tumor tissue. The tumor was infiltrated subependymally into ventricular systems with intramedullary invasions in some places. Histological diagnosis was glioblastoma multiforme.