A case of lumbar myxopapillary ependymoma discovered due to headache

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  • Nozaki Ichiro
    Department of Neurology, Ishikawa Prefectural Central Hospital Department of Neurology, National Iou Hospital
  • Matsumoto Yasuko
    Department of Neurology, Ishikawa Prefectural Central Hospital
  • Yamaguchi Kazuyoshi
    Department of Neurology, Ishikawa Prefectural Central Hospital
  • Shimizu Yu
    Department of Neurosurgery, Ishikawa Prefectural Central Hospital
  • Kumahashi Kazuhiko
    Department of Neurosurgery, Ishikawa Prefectural Central Hospital
  • Munemoto Shigeru
    Department of Neurosurgery, Ishikawa Prefectural Central Hospital

Bibliographic Information

Other Title
  • 頭痛を契機に発見された腰部粘液乳頭状上衣腫の1 例
  • 症例報告 頭痛を契機に発見された腰部粘液乳頭状上衣腫の1例
  • ショウレイ ホウコク ズツウ オ ケイキ ニ ハッケン サレタ ヨウブ ネンエキ ニュウトウジョウ ウワギ シュ ノ 1レイ

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Abstract

A 23-year-old man was admitted to our hospital with lumbago about two weeks previously, and headache six days previously. Brain MR imaging revealed no remarkable findings except for left ethmoid sinusitis; both MR angiography and venography showed no vascular abnormalities. On the day after admission, lumbar puncture was performed because right homonymous hemianopsia and nuchal stiffness developed. The cerebrospinal fluid appeared bloody, and the source of bleeding was searched for. MR images of the lumbar spine demonstrated an intradural tumor with heterogenous contrast enhancement, and this tumor was considered to be the source of the bleeding. Tumor resection was performed, but some parts of the tumor could not be resected because of adhesion to the cauda equina. The pathological findings of the tumor demonstrated myxopapillary ependymoma. Radiation therapy was added to treat the residual tumor because myxopapillary ependymoma tended to recur in spite of the benign nature of the tumor. Spinal myxopapillary ependymoma is rare, but it causes subarachnoid hemorrhage. Subarachnoid hemorrhage from spinal tumor should be suspected when headache accompanied with severe low back pain are present even in the absence of spinal signs.

Journal

  • Rinsho Shinkeigaku

    Rinsho Shinkeigaku 53 (2), 136-142, 2013

    Societas Neurologica Japonica

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