An unusual clinical presentation of cervical extradural meningiomas and detected with neuromuscular ultrasound: A case report and literature review

Abstract

Background: Extradural meningiomas are exceedingly rare, with most occurring in the thoracic region. If the tumor occurs in the cervical region, it may invade the adjacent nerve root and brachial plexus. Usually, the patient may not be diagnosed until presenting with signs of myelopathy, such as progressive paresis and numbness. Case presentation: We report a 64-year-old male patient with neck pain followed by numbness and very mild weakness of the left hand for 6 months. The general neurological examination was grossly normal expect for mild grasping weakness over left side. Neuromuscular ultrasound revealed a lesion over the left 7th cervical root. The patient received subtotal tumor excision followed by radiotherapy for residual tumor. Histopathology revealed atypical meningioma (WHO grade II). Conclusion: Neuromuscular ultrasound allowed for detection and diagnosis cervical brachial plexus tumor at an early stage before significant focal neurological defects developed.