Intradural cervical lipomas with intracranial extension: a management strategy based on a case report and review of the literature.
Intradural cervical lipomas with intracranial extension are very rare. There have been 12 previously reported cases. We report an 18-year-old female who presented with quadraparesis and incontinence, and review the previously published literature. Intradural lipomas with intracranial extension occur in younger patients when compared with those without intracranial extension. Roughly half of high cervical lipomas have intracranial extension. This results in a more complicated course of surgical management and a worse prognosis. While the relatively older patients most commonly present with quadriplegia, in younger patients there may be a more variable presentation. Almost half the patients had symptoms ascribable to the intracranial component. In all patients, no more than subtotal resection and decompression was achieved using duroplasty if necessary. Only five patients showed functional recovery. We propose a management strategy for this condition.
Le Feuvre
D E J
DE
Department of Neurosurgery, Groote Schuur Hospital, Observatory, Cape Town, South Africa. davidlefeuvre@hotmail.com
Semple
P L
PL
Peter
J C
JC
D000293:Adolescent; D001932:Brain Neoplasms / Q000473:pathology / Q000601:surgery*; D002574:Cervical Vertebrae; D004388:Dura Mater / Q000473:pathology*; D005260:Female; D006801:Humans; D008067:Lipoma / Q000473:pathology / Q000601:surgery*; D008577:Meningeal Neoplasms / Q000473:pathology / Q000601:surgery*; D011782:Quadriplegia / Q000209:etiology / Q000473:pathology; D013120:Spinal Cord Neoplasms / Q000473:pathology / Q000601:surgery*; D014549:Urinary Incontinence / Q000209:etiology