Khoshyomn Sami, Barth Konrad N M, Christman Robert A, Braff Steven P, Wilson James T
Division of Neurosurgery, Department of Surgery, University of Vermont College of Medicine, Burlington, Vt., USA.
Pediatr Neurosurg. 2002 Oct;37(4):206-9. doi: 10.1159/000065392.
We report a very rare case of a lumbar nerve root schwannoma presenting with torsion and infarction. The patient was a 16-year-old male presenting with severe low back pain and urinary retention following an aggressive game of hockey. Subsequent MRI of the lumbar spine revealed a nonenhancing lumbar intradural lesion at the level of L3. The patient was taken to the operating room where he underwent a bilateral L2 and L3 laminectomy and gross total resection of an intradural nerve root tumor, which appeared to have undergone torsion and infarction. Subsequent histopathological examination of the surgical specimen verified the diagnosis of infarcted schwannoma. This is a unique case of lumbar nerve root schwannoma, with atypical MRI findings, presenting with infarction due to torsion of the involved nerve root.
我们报告了一例极为罕见的腰椎神经根神经鞘瘤伴扭转和梗死的病例。患者为一名16岁男性,在一场激烈的曲棍球比赛后出现严重的下背痛和尿潴留。随后的腰椎磁共振成像(MRI)显示L3水平有一个无强化的腰椎硬膜内病变。患者被送往手术室,在那里接受了双侧L2和L3椎板切除术,并对硬膜内神经根肿瘤进行了大体全切,该肿瘤似乎已经发生了扭转和梗死。随后对手术标本进行的组织病理学检查证实了梗死性神经鞘瘤的诊断。这是一例独特的腰椎神经根神经鞘瘤病例,具有非典型的MRI表现,因受累神经根扭转而出现梗死。