四肢麻痺にて発症した巨大 C1 神経鞘腫の 1 例

概要

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We report a surgical case of a huge C1 neurinoma causing sudden onset of tetraplegia. A 45-year-old man, who had suffered from occipitalgia, numbness and mild motor weakness of the four extremities, became tetraplegic just after a cervical hyperextension injury. An MRI revealed a huge intradural mass severely compressing the medulla oblongata and upper cervical spinal cord. Suboccipital craniectomy, laminectomy from C1 to C3 and tumor biopsy were urgently performed. The histological examination confirmed a neurinoma. Although the tetraplegia slightly improved after decompression surgery, the symptoms worsened again. Ten days after the first surgery, the tumor was totally removed. The symptoms improved remarkably following the second surgery and the patient was discharged ambulatory. He returned to his previous job 6 months after surgery. Diagnosis of neurinomas in this region is difficult simply from the clinical states in the early stage. The possibility of this lesion must be considered when seeing a patient with occipitalgia, numbness and mild motor weakness of the four extremities even if those symptoms are subtle. Even when symptoms are severe, marked improvement can be expected following surgery.
日本脊髄外科学会の論文
2002-11-30