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Spinal Schwannoma with Intradural Intramedullary Hemorrhage

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ABSTRACT

Patients with spinal abnormalities infrequently present with intradural intramedullary bleeding. The more common causes include spinal trauma, arteriovenous malformations and saccular aneurysms of spinal arteries. On occasion, spinal cord tumors either primary or metastatic may cause intramedullary bleed with ependymoma of the conus medullaris. Spinal nerve sheath tumors such as schwannomas only rarely cause intradural intramedullary bleed, especially in the absence of spinal cord or nerve root symptoms. We report a case of spinal intradural schwannoma presenting with acute onset of quadriparesis. Cerebral angiography studies were negative but magnetic resonance imaging (MRI) of the spine revealed a large hemorrhagic tumor in the thoracolumbar junction. However, we suggest that the patients with intradural intramedullary bleed should be evaluated for underlying spine disease.

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MRI of thoracolumbar spinal tumorSagittal T2- [A] and T1-weighted [B] imaging shows a heterogeneous signal intensity of large mass at the conus medullaris (red arrows). The two hyperintense subdural hematomas located caudal to the mass (blue arrows). There is heterogeneous enhancement of the mass post-intravenus contrast [C]
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FIG1: MRI of thoracolumbar spinal tumorSagittal T2- [A] and T1-weighted [B] imaging shows a heterogeneous signal intensity of large mass at the conus medullaris (red arrows). The two hyperintense subdural hematomas located caudal to the mass (blue arrows). There is heterogeneous enhancement of the mass post-intravenus contrast [C]

Mentions: Biochemical laboratory studies were unremarkable except for a mild decrease in levels of sodium (132 mEq/L), potassium (3.3 mEq/L) and chloride (92 mEq/L). MRI T1-weighted images show a large mass at the conus medullaris with heterogeneous signal intensity (Figure 1). MRI spine shows hyperintense subdural blood collections located both anterior and posterior to the cauda equina (Figure 2).


Spinal Schwannoma with Intradural Intramedullary Hemorrhage
MRI of thoracolumbar spinal tumorSagittal T2- [A] and T1-weighted [B] imaging shows a heterogeneous signal intensity of large mass at the conus medullaris (red arrows). The two hyperintense subdural hematomas located caudal to the mass (blue arrows). There is heterogeneous enhancement of the mass post-intravenus contrast [C]
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5383370&req=5

FIG1: MRI of thoracolumbar spinal tumorSagittal T2- [A] and T1-weighted [B] imaging shows a heterogeneous signal intensity of large mass at the conus medullaris (red arrows). The two hyperintense subdural hematomas located caudal to the mass (blue arrows). There is heterogeneous enhancement of the mass post-intravenus contrast [C]
Mentions: Biochemical laboratory studies were unremarkable except for a mild decrease in levels of sodium (132 mEq/L), potassium (3.3 mEq/L) and chloride (92 mEq/L). MRI T1-weighted images show a large mass at the conus medullaris with heterogeneous signal intensity (Figure 1). MRI spine shows hyperintense subdural blood collections located both anterior and posterior to the cauda equina (Figure 2).

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Patients with spinal abnormalities infrequently present with intradural intramedullary bleeding. The more common causes include spinal trauma, arteriovenous malformations and saccular aneurysms of spinal arteries. On occasion, spinal cord tumors either primary or metastatic may cause intramedullary bleed with ependymoma of the conus medullaris. Spinal nerve sheath tumors such as schwannomas only rarely cause intradural intramedullary bleed, especially in the absence of spinal cord or nerve root symptoms. We report a case of spinal intradural schwannoma presenting with acute onset of quadriparesis. Cerebral angiography studies were negative but magnetic resonance imaging (MRI) of the spine revealed a large hemorrhagic tumor in the thoracolumbar junction. However, we suggest that the patients with intradural intramedullary bleed should be evaluated for underlying spine disease.

No MeSH data available.


Related in: MedlinePlus