• Eur Spine J · May 2016

    Review Case Reports

    Surgical treatment for posttraumatic hemorrhage inside a filum terminale myxopapillary ependymoma: a case report and literature review.

    • Daijiro Morimoto, Toyohiko Isu, Kyongsong Kim, Masanori Isobe, Tatsuro Takahashi, Yusuke Ishida, Hidehiro Takei, and Akio Morita.
    • Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido, Japan. dai_sampo@yahoo.co.jp.
    • Eur Spine J. 2016 May 1; 25 Suppl 1: 239-44.

    PurposeSymptoms of cauda equina syndrome due to ependymoma in the conus medullaris or filum terminale develop slowly. However, hemorrhagic change inside spinal tumors can induce acute neurologic decline. Here, we report a case of posttraumatic hemorrhage inside a filum terminale myxopapillary ependymoma presenting as acute neurologic decline, which had a positive prognosis after surgical resection.MethodsA 28-year-old man presented with buttock pain, sensory disturbance, and motor weakness of bilateral lower extremities after falling on ice during smelt fishing. Magnetic resonance imaging demonstrated a mixed-intensity hemorrhagic intradural mass extending from L1 to L2.ResultsThe patient underwent emergent surgical decompression and resection. Pathologic examination revealed a myxopapillary ependymoma with intratumoral hemorrhage. After surgery, the patient demonstrated gradual improvement in neurologic deficits and no tumor recurrence.ConclusionsThis is the first case of a filum terminale myxopapillary ependymoma with an acute neurologic decline after injury. Early diagnosis and treatment are associated with favorable outcomes.

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