title: Cervical spinal cord infarction after surgery for a pineal region choriocarcinoma in the sitting position: case report.
abstract: OBJECTIVE
  Spinal cord injury is one of several devastating complications after operation in the sitting position. Young patients exhibiting extraordinary growth spurts demonstrate a higher risk for this complication.
  
  
  METHODS
  We describe a 7-year-old male patient with a pineal region choriocarcinoma in whom a cervical spinal cord infarction (C5-T1) developed as an acute complication after operation in the sitting position. Preoperatively, high serum levels of human chorionic gonadotropin (5867.7 mIU/ml) and somatomedin-C (704 ng/ml) and an extreme growth velocity in height (16 cm/yr) were noted.
  
  
  CONCLUSIONS
  It is assumed that, in addition to head flexion, the abnormal skeletal growth spurt resulting from an excessive secretion of human chorionic gonadotropin from a tumor was a possible predisposing factor for this complication. To prevent this complication, surgeons need to pay great attention to head positioning, especially in a young patient experiencing an active growth spurt.
authors.affiliation: Department of Neurosurgery, School of Medicine, Kanazawa University, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Nitta
authors.forename: J
authors.initials: J
authors.lastname: Yamashita
authors.forename: M
authors.initials: M
authors.lastname: Nomura
authors.forename: N
authors.initials: N
authors.lastname: Igarashi
mesh_terms: D001932:Brain Neoplasms / Q000601:surgery*; D002648:Child; D002822:Choriocarcinoma / Q000601:surgery*; D006801:Humans; D007238:Infarction / Q000175:diagnosis / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D010870:Pineal Gland / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D011187:Posture / Q000502:physiology; D012307:Risk Factors; D013116:Spinal Cord / Q000098:blood supply*