Shahat Abdul Hameed, Obaideen A M, Ahmed Khalid, Ahmed Shakeel
Neurosurgery Department, North West Armed Forces Hospital, Tabuk, Saudi Arabia.
Surg Neurol. 2006 May;65(5):486-9. doi: 10.1016/j.surneu.2005.09.035.
An unusual case of an extensive intramedullary lipoma of the cervicodorsal spinal cord with intracranial extension causing compression of spinal cord and brainstem is described.
A 3-year-old child with lack of limb movement since birth, the cause of which had remained obscure, developed opisthotonos and episodes of severe respiratory difficulty with brief periods of apnea. Craniospinal computed tomography and magnetic resonance imaging (MRI) were diagnostic of lipoma. Urgent occipitocervical decompression and subtotal removal of the posterior fossa and cervical spinal cord lipoma resulted in lasting resolution of symptoms.
Extensive spinal cord lipomas with intracranial extension can present with alarming spinal cord/medullary compression and respiratory symptoms. Computed tomographic scan and MRI are diagnostic. Total removal is not feasible, or necessary, because subtotal removal and decompression give long-lasting resolution of symptoms.
本文描述了一例罕见的广泛累及颈胸段脊髓的髓内脂肪瘤,该脂肪瘤向颅内延伸,导致脊髓和脑干受压。
一名3岁儿童自出生以来就缺乏肢体活动能力,病因不明,现出现角弓反张以及严重呼吸困难并伴有短暂呼吸暂停发作。头颅脊髓计算机断层扫描和磁共振成像(MRI)诊断为脂肪瘤。紧急进行枕颈减压并次全切除后颅窝和颈段脊髓脂肪瘤,症状得到持久缓解。
广泛的伴有颅内延伸的脊髓脂肪瘤可表现为令人担忧的脊髓/延髓压迫和呼吸症状。计算机断层扫描和MRI可用于诊断。由于次全切除和减压能使症状得到持久缓解,因此完全切除既不可行也无必要。