title: Spinal cord lipoma without dysraphism in the infancy that extends intracranially. Case report and review of the literature.
abstract: BACKGROUND
  Spinal intramedullary lipoma extending to the posterior fossa is very rare in children. We made a revision of the literature and report the diverse opinions and surgical procedures.
  
  
  METHODS
  We report the case of a 16-month-old male infant who was operated on in the Pediatric Neurosurgical Unit of our hospital; his clinical and surgical outcome are related.
  
  
  CONCLUSIONS
  Intramedullary lipoma of the spinal cord with intracranial extension in infancy is a very rare pathology reported in the literature. Our patient was treated with decompression and subtotal removal; he had a critical postoperative course but was recovering slowly after that. Most authors prefer incomplete resection because these lesions do not have a clear-cut margin. Another neurosurgeon performed a decompression only, without resection. Some authors performed the surgical treatment before symptom progression. Another surgeon reported that the surgical indication is debatable when the neurologic manifestations are poor or absent. The surgical indication and the strategy for treatment are controversial and they depend on the clinical situations of the patients.
authors.affiliation: Pediatric Neurosurgical Unit, Department of Neurosurgery, Universitary Hospital La Fe, Valencia, Spain. vila_man@gva.es
authors.forename: Manuel
authors.initials: M
authors.lastname: Vila Mengual
authors.forename: Pablo
authors.initials: P
authors.lastname: Miranda Lloret
authors.forename: Antonio
authors.initials: A
authors.lastname: López González
authors.forename: Juan A
authors.initials: JA
authors.lastname: Simal
authors.forename: Jose A
authors.initials: JA
authors.lastname: Alvarez Garijo
mesh_terms: D001933:Brain Stem / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D002574:Cervical Vertebrae / Q000601:surgery; D003388:Cranial Fossa, Posterior / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D003399:Craniotomy; D019299:Decompression, Surgical; D005402:Fistula / Q000209:etiology; D006429:Hemiplegia / Q000209:etiology; D006801:Humans; D007223:Infant; D007796:Laminectomy; D008067:Lipoma / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery; D009361:Neoplasm Invasiveness / Q000473:pathology* / Q000503:physiopathology; D019635:Neurosurgical Procedures; D009777:Occipital Bone / Q000601:surgery; D011183:Postoperative Complications / Q000473:pathology / Q000503:physiopathology; D011782:Quadriplegia / Q000209:etiology; D019651:Plastic Surgery Procedures; D013116:Spinal Cord / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D013120:Spinal Cord Neoplasms / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome