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

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Abstract

Purpose

Symptoms 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.

Methods

A 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.

Results

The 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.

Conclusions

This 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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Acknowledgments

We would like to thank Editage (www.editage.jp) for English language editing.

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Authors and Affiliations

  1. Department of Neurosurgery, Kushiro Rosai Hospital, Hokkaido, Japan

    Daijiro Morimoto, Toyohiko Isu & Masanori Isobe

  2. Department of Neurosurgery, Nippon Medical School Chiba Hokuso Hospital, Chiba, Japan

    Kyongsong Kim

  3. Department of Pathology, Kushiro Rosai Hospital, Hokkaido, Japan

    Tatsuro Takahashi & Yusuke Ishida

  4. Department of Diagnostic Pathology, Asahikawa Medical University, Hokkaido, Japan

    Hidehiro Takei

  5. Department of Neurological Surgery, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan

    Daijiro Morimoto & Akio Morita

Authors
  1. Daijiro Morimoto
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  2. Toyohiko Isu
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  3. Kyongsong Kim
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  4. Masanori Isobe
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  5. Tatsuro Takahashi
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  6. Yusuke Ishida
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  7. Hidehiro Takei
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  8. Akio Morita
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Corresponding author

Correspondence to Daijiro Morimoto.

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Conflict of interest

The authors report no conflicts of interest concerning the materials or methods used in this study or the findings specified in this paper.

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Morimoto, D., Isu, T., Kim, K. et al. Surgical treatment for posttraumatic hemorrhage inside a filum terminale myxopapillary ependymoma: a case report and literature review. Eur Spine J 25 (Suppl 1), 239–244 (2016). https://doi.org/10.1007/s00586-016-4521-5

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  • DOI: https://doi.org/10.1007/s00586-016-4521-5

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