A 37-year-old woman was admitted to the department of Neurosurgery, Seoul National University Hospital through emergency room complaining of weakness and numbness of both lower limbs of about 5 months duration.
Initially she complained of girdle pain in the right lower chest region which was persisted,until admission.Seven months prior to admission, she felt progressive weakness of her both lower limbs and finally she was unable to walk since 5 months prior to admission when she felt a decreased pain sensation in her both legs.
But her sphincter control was relatively intact until 3 months ago, and thereafter she felt slight weakness of urinary streams.Neurologic examination on admission revealed sweating level at T6, decreased pain and temperature sensation below T6 on both sides (especially on the left side), absent touch and position sense, inability of flexion of right lower limb and markedly decreased flexion power in left lower limb with intact bilateral extension, hyperactive deep tendon reflexes, strongly positive ankle clonus on both sides, and evident bilateral toe signs.
Simple spine x-ray showed the erosion of pedicles of T5,6 and 7, and myelogram demonstrated the total block at the lower border of T9.
Laminectomy was done from T3 to T10 and when a midline dural incision was made, greyish red and highly vascularized soft tumor, which occupied the entire cord substance and was unable to separate from the normal cord, was protuded out and its biopsy was turned out to be a typical neurilemmoma.
After operation, she was improved in the.neurological deficits in some extents.
|