• Li Ming Dai, Yong Qiu, Bo Cen, and Jing Lv.
• Department of Neurosurgery, Wuhan Brain Hospital, Wuhan City, Hubei Province, China.
• World Neurosurg. 2019 Jul 1; 127: 418-422.

BackgroundIntramedullary schwannomas of the spinal cord are extremely rare. Most previous studies are case reports, which have found that intramedullary schwannomas could be homogeneous or asymmetrically enhanced with gadolinium. However, intramedullary schwannomas with minimal enhancement have not been reported.Case DescriptionThis article describes a 34-year-old patient who presented with nonradiative neck pain, progressive weakness of the left limbs, and sensory deficit of both lower extremities. Preoperative examinations such as magnetic resonance imaging (MRI) were performed, and the patient underwent surgical treatment. MRI showed that the lesion presented unsharp enhancement with gadolinium on T1-weighted images. Histopathologic findings were consistent with the diagnosis of schwannoma.ConclusionsWe report a case of intramedullary schwannoma that presented inconspicuous enhancement with gadolinium. MRI is useful but cannot be used to differentiate schwannomas from other intramedullary spinal tumours. Surgical resection is the most vital factor for the treatment of intramedullary schwannoma.Copyright © 2019 Elsevier Inc. All rights reserved.

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