Craniocervical intradural pseudotumor causing bulbomedullary compression

Pseudotumors are rare lesions that may cause compression of adjacent neural structures. Treatment options range from conservative management to surgical intervention.

A 59-year-old female presented with a 3-month history of headaches, difficulty speaking, swallowing, gait disturbance, and progressive left-sided weakness. Her examination confirmed left-sided tetraparesis. The cervical magnetic resonance showed a right-sided mass compressing the bulbomedullary junction. Through a modified right-sided far lateral craniotomy, an intradural "pseudotumor" was removed. Postoperatively, the patient's symptoms gradually improved. Histopathological analysis revealed an acellular fibrocartilaginous mass consistent with the diagnosis of pseudotumor.

Pseudotumors at the craniocervical junction may cause progressive tetraparesis readily resolved following gross total surgical excision.