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无创伤史的颈段硬膜内创伤性神经瘤:病例说明

Cervical intradural traumatic neuroma without history of trauma: illustrative case.

作者信息

Elias Elias, Hatanpaa Kimmo J, MacAllister Matthew, Daoud Ali, Elias Charbel, Nasser Zeina

机构信息

1Department of Neurosurgery, University of Texas Southwestern, Dallas, Texas.

2Pathology, University of Texas Southwestern, Dallas, Texas.

出版信息

J Neurosurg Case Lessons. 2023 Sep 18;6(12). doi: 10.3171/CASE23423.

Abstract

BACKGROUND

Traumatic neuroma typically refers to a reactive process in the injured peripheral nerve, characterized by an excessive growth of axons, Schwann cells, and fibroblasts at the proximal end of the nerve after its interruption. The authors report a case of a traumatic neuroma in the cervical nerve root in a patient with no history of trauma.

OBSERVATIONS

The patient presented with sensation loss in the right-hand ulnar distribution, right flank around the T4-11 region, and right small toe along with motor power weakness over the right upper and lower extremity. Magnetic resonance imaging revealed an intradural extramedullary mass lesion with extension along the C7 nerve root. Histological examination showed traumatic neuroma. A total resection of the lesion along with the resolution of sensory and motor deficits was achieved directly after surgery.

LESSONS

Traumatic neuroma should always be kept in the armamentarium for diagnosis of an intradural nerve sheath tumor.

摘要

背景

创伤性神经瘤通常指受伤的周围神经的一种反应性过程,其特征是神经中断后在神经近端轴突、施万细胞和成纤维细胞过度生长。作者报告了一例无创伤史患者颈神经根创伤性神经瘤的病例。

观察结果

患者出现右手尺侧分布区、T4 - 11区域周围右侧胁腹以及右小趾感觉丧失,同时右上肢和下肢肌力减弱。磁共振成像显示硬膜内髓外肿块病变沿C7神经根延伸。组织学检查显示为创伤性神经瘤。手术后直接实现了病变的完全切除以及感觉和运动功能障碍的缓解。

经验教训

在诊断硬膜内神经鞘瘤时,创伤性神经瘤应始终被纳入鉴别诊断范围。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59ea/10555639/851b20212045/CASE23423f1.jpg

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