Thoracolumbar intraspinal tumours presenting features of raised intracranial pressure.

Ridsdale, Leone; Moseley, I. F.

doi:10.1136/jnnp.41.8.737

Cited by 70 publications

(30 citation statements)

References 18 publications

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“…Several reports of intradural spinal neoplasms leading to increased intracranial pressure have been published, [8][9][10][11][12] with 2 theories postulated to explain this. One involves elevated pressure due to increased CSF protein, which interferes with CSF absorption at the level of the arachnoid villi.…”

Section: Discussionmentioning

confidence: 99%

A case of indirect cauda equina syndrome from metastatic prostate cancer

Lefresne

Fairchild

Bistritz

et al. 2013

CUAJ

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We report the case of a patient with metastatic hormone refractory prostate cancer in whom "indirect" cauda equina syndrome developed concurrent with multilevel spinal cord compression (SCC). Three months after his first positive bone scan, a 65-yearold otherwise healthy man presented with severe back pain, bilateral lower extremity paresthesias, leg weakness and urinary retention. Magnetic resonance imaging (MRI) showed a dural-based mass causing SCC at the T9, T10 and T11 vertebrae, with a normal cauda equina. He received corticosteroids and palliative external beam radiotherapy, resulting in good pain control and gradual improvement in his neurological symptoms. He did well for 8 months, at which time his residual bilateral leg weakness abruptly worsened and he experienced numbness, paresthesias, urinary incontinence and constipation. Repeat MRI showed progression of epidural metastatic disease compressing the spinal cord or thecal sac at 7 thoracic vertebral levels. The cauda equina was also distorted and flattened without evidence of direct solid tumour impingement. We hypothesized that the etiology was increased intrathecal pressure due to disrupted cerebrospinal fluid flow resulting from multiple levels of upstream thecal sac compression. It is essential to image the entire spinal cord and cauda equina when patients with metastatic bone disease present with neurological symptoms to institute correct treatment and preserve function and mobility.Can Urol Assoc J 2009;3(4):E31-E35 pathological fracture, an intramedullary lesion or a combination of these factors.5 Both oncological emergencies require early diagnosis and treatment to prevent the development of devastating and potentially irreversible neurological complications. We present a unique case of CES secondary to increased cerebrospinal fluid (CSF) pressure as a result of multilevel upstream malignant SCC in a patient with prostate cancer.

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Section: Discussionmentioning

confidence: 99%

A case of indirect cauda equina syndrome from metastatic prostate cancer

Lefresne

Fairchild

Bistritz

et al. 2013

CUAJ

View full text Add to dashboard Cite

show abstract

“…We summarized the previously reported cases of neurinoma with hydrocephalus in Table 1 [4][5][7][8][9][10]. Middle-age, female gender, and high CSF protein levels are risk factors of sNPH with spinal neurinoma.…”

Section: Discussionmentioning

confidence: 99%

Resection of Multiple Neurinomas of the Cauda Equina Improves Normal Pressure Hydrocephalus

Fuse¹,

Nishioka²,

Shimura³

et al. 2012

OJMN

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Normal pressure hydrocephalus (NPH) is a treatable neurological condition characterized by dementia, gait disturbances, and urinary incontinence. This case study aimed to evaluate the effectiveness of surgical intervention in treating NPH associated with spinal cord tumors. A patient suffering with NPH underwent a spinal tap procedure and surgical resectioning of three neurinomas on the cauda equina. The patient exhibited marked improvement in neurological and motor symptoms related to NPH following surgical intervention. These findings suggest that surgical resectioning of neurinomas is an effective intervention for treating NPH associated with spinal cord tumors.

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“…4 Any changes of this balanced system will lead to increased intracranial pressure and papilloedema even without ventriculomegaly in a pseudotumour-like condition. 5 Spinal tumours may in fact reduce the capacity of this reservoir and cause elevated intracranial pressure. 6 In this case, the mass effect of the cSDH was an additional factor, further compromising the CSF space and dynamic system and may have been the cause of sudden deterioration of symptoms.…”

Section: Discussionmentioning

confidence: 99%

Papilloedema in association with spinal lipoma and bilateral chronic subdural bleeding

2007

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Study design: A case report describing a patient presenting with papilloedema, headache and saddle hypoesthesia caused by a lumbo-sacral intraspinal extradural lipoma in the presence of a bilateral chronic subdural haematoma (cSDH). Objective: The aim of this report is to discuss the pathophysiology of papilloedema in spinal tumours and the effect of the cSDH on the development of papilloedema. A search of the Medline database yielded no case reports describing papilloedema arising from spinal extradural lipoma in the presence of intracranial cSDH. Setting: Department of Neurosurgery, Unfallkrankenhaus Berlin, Berlin, Germany. Case report: We report a clinical case of cauda equina compression due to an extradural lipoma presenting with papilloedema. Cranial computer tomography (CT-scan) additionally revealed a thin, bilateral cSDH. The patient underwent surgical excision of the lipoma subsequent to an L5-S3 laminectomy. On duratomy, a membranous thrombus formation was discovered between the nerve filaments. The patient experienced clinical improvement with regression of his neurological symptoms. Histological findings confirmed the diagnosis of lipoma and intradural thrombus. Conclusion: Spinal tumours may cause complex cerebrospinal fluid (CSF) dynamic and resorptive changes. These changes are mechanical, physiological or combined in their effect. Patients with papilloedema or increased intracranial pressure should be carefully examined by clinical and neuroradiological means for cranial and spinal pathologies. The treatment of the primary cause might save the patient a series of unnecessary procedures.

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Thoracolumbar intraspinal tumours presenting features of raised intracranial pressure.

Cited by 70 publications

References 18 publications

A case of indirect cauda equina syndrome from metastatic prostate cancer

A case of indirect cauda equina syndrome from metastatic prostate cancer

Resection of Multiple Neurinomas of the Cauda Equina Improves Normal Pressure Hydrocephalus

Papilloedema in association with spinal lipoma and bilateral chronic subdural bleeding

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