title: Acute neurological deterioration as a result of two synchronous hemorrhagic spinal ependymomas.
abstract: BACKGROUND
  Ependymomas are the most common intramedullary tumors in adults and are the most common in mid-adult years. The presence of synchronous ependymomas in different sites of the spine is not common and it is even more infrequent to find hemorrhage from a spinal ependymoma as a cause of neurological deterioration.
  
  
  METHODS
  A 32-year-old man presented with back pain and progressive paraparesia. Magnetic resonance (MR) showed two intradural extramedullary lesions on spinal canal with signs of acute hemorrhage. The patient underwent emergent surgical decompression and resection. Pathology revealed myxopapillary ependymomas.
  
  
  CONCLUSIONS
  To our knowledge, we report the first case of a patient with acute neurological deterioration as a consequence of synchronous bleeding of two spinal ependymomas located at different levels in the spinal cord. This study illustrates the importance of recognizing the rare, but known occurrence of acute neurological deterioration after spontaneous hemorrhage in spinal ependymomas.
authors.affiliation: Department of Neurosurgery, "12 Octubre" University Hospital, Madrid, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: Martinez-Perez
authors.forename: Aurelio
authors.initials: A
authors.lastname: Hernandez-Lain
authors.forename: Igor
authors.initials: I
authors.lastname: Paredes
authors.forename: Pablo M
authors.initials: PM
authors.lastname: Munarriz
authors.forename: Ana M
authors.initials: AM
authors.lastname: Castaño-Leon
authors.forename: Alfonso
authors.initials: A
authors.lastname: Lagares