Functional Tolerance of the Cervical Cord in Giant Ependymoma

Abstract

Author reports to a 42-year-old man who suffered motor impairment in his limbs since 17-years of age, and five years later he presented central pain. In August 2011, a preoperative MRI scans showed syringobulbia and a giant intramedullary tumor, which occupied 70% of the cervical cord. The neoplasm was surgically removed and the histological study was recognized as cellular ependymoma. At present, 56 months after surgery the patient can walk with or without assistance and persists with central pain. This patient confirms previous observations that in dyscomplete transection there are axons in function and that could improve after a decompression or revascularization. Moreover, this patient confirms that there is a huge tolerance of the spinal cord to chronic injuries.

Etiopathogenesis of Central Nervous System Gliomas

“…But there are anatomical [98][99][100] and pathological [101][102][103][104] findings that could explain the genesis of syringomyelia such as: 1) location of the ependymal duct within the spinal cord; 2) vascularization of peri-ependymal parenchyma by arterioles and capillaries [99,100]; 3) anatomical variants of spinal cord vascularization [98,99], and 4) degree of dilatation of syringomyelia. Therefore on the basis of the abovementioned data, I believe that in the zones of greater dilatation there are peri-ependymal zones with varying degrees of ischemia and hypoxia.…”