繰り返す頭痛にて発症した馬尾部 myxopapillary ependymoma の 1 例

概要

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An unusual case demonstrating initial symptoms of recurrent headaches which was due to a hemorrhagic spinal myxopapillary ependymoma was presented. A 31-year-old woman kinder garden teacher visited an orthopedic clinic complaining of a sudden severe headache followed by low back pain and left leg sciatic pain after picking-up a child. Diagnosis was lumbar disc herniation. With conservative treatment manifestations diminished shortly, and she returned to her occupation. Seven months later, she complained of the same symptoms while running with children. A magnetic resonance image demonstrated a hemorrhagic tumor in the lumbosacral lesion and she was sent to our institution. As spinal fluid was hemorrhagic, subarachnoid hemorrhage due to the spinal tumor was considered. The tumor was totally resected without neurological deficits, and the histological diagnosis was myxopapillary ependymoma. Ependymomas are known for the risk of hemorrhage, however subarachnoid hemorrhage due to spinal tumors are rare. Shear stress due to motional changes between the spinal column and the surface of the tumor attached to the filum terminal may have caused mechanical trauma causing damage to the blood vessels on the surface of the tumor which created subarachnoid hemorrhage.
日本脊髄外科学会の論文
2003-11-30