An Unusual Onset of a Spinal Cord Tumour: Subarachnoid Bleeding and Papilloedema - Case report

Abstract

A rare case of intracranial hypertension associated with subarachnoid bleeding from a spinal tumour is reported. Clinical features, review of the literature and pathogenetic factors are discussed.

Atypical presentations of conus medullaris and filum terminale myxopapillary ependymomas

“…In our cases, the rich vascular network of myxopapillary ependymomas can easily explain the spinal SAH, knowing the fact that these tumours were implicated in more than 60% of spinal SAH. 15 The development of intracranial hypertension and hydrocephalus from spinal tumours is quite a rare occurrence. 9;10;15 It is difficult to account for the development of intracranial hypertension or hydrocephalus in subjects with tumours of the lumbar region, while the presence of this syndrome in patients with cervical spinal cord or craniovertebral junction tumours can be easily explained by the mechanism of obstruction of the spinal fluid pathways.…”

Spinal subarachnoid hermorrhage associated with leptomeningeal metastases

“…Spontaneous SAH of spinal origin is rare, mostly related to spinal arteriovenous malfomations [2,10] and only infrequently to spinal tumors [1][2][3][4][5]. The bleeding tumors arise locally and are of neuroaxial or nerve sheath origin.…”

“…The bleeding tumors arise locally and are of neuroaxial or nerve sheath origin. Among these tumors ependymoma is the most common source of bleeding [1]. An acute onset of either back or radicular pain followed by signs of spinal cord or nerve roots dysfunction characterize spinal bleeding but sometimes symptoms and signs may not be distinguished from intracranial SAH [3,4].…”

“…Subarachnoid hemorrhage (SAH) complicating spinal intradural tumor is rare, and is most frequently reported in association with ependymomas [1]. Occasionally the bleeding is related to neurofibromas, meningiomas, astrocytomas or other locally arising neoplasms [1][2][3][4][5].…”

“…Occasionally the bleeding is related to neurofibromas, meningiomas, astrocytomas or other locally arising neoplasms [1][2][3][4][5]. Metastatic intradural extramedullary tumors associated with SAH have been previously described in only 2 case reports [6,7].…”