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Papilloedema in association with spinal lipoma and bilateral chronic subdural bleeding.
Spinal Cord. 2008 May; 46(5):392-4.SC

Abstract

STUDY DESIGN

A case report describing a patient presenting with papilloedema, headache and saddle hypoesthesia caused by a lumbo-sacral intraspinal extradural lipoma in the presence of a bilateral chronic subdural haematoma (cSDH).

OBJECTIVE

The aim of this report is to discuss the pathophysiology of papilloedema in spinal tumours and the effect of the cSDH on the development of papilloedema. A search of the Medline database yielded no case reports describing papilloedema arising from spinal extradural lipoma in the presence of intracranial cSDH.

SETTING

Department of Neurosurgery, Unfallkrankenhaus Berlin, Berlin, Germany.

CASE REPORT

We report a clinical case of cauda equina compression due to an extradural lipoma presenting with papilloedema. Cranial computer tomography (CT-scan) additionally revealed a thin, bilateral cSDH. The patient underwent surgical excision of the lipoma subsequent to an L5-S3 laminectomy. On duratomy, a membranous thrombus formation was discovered between the nerve filaments. The patient experienced clinical improvement with regression of his neurological symptoms. Histological findings confirmed the diagnosis of lipoma and intradural thrombus.

CONCLUSION

Spinal tumours may cause complex cerebrospinal fluid (CSF) dynamic and resorptive changes. These changes are mechanical, physiological or combined in their effect. Patients with papilloedema or increased intracranial pressure should be carefully examined by clinical and neuro-radiological means for cranial and spinal pathologies. The treatment of the primary cause might save the patient a series of unnecessary procedures.

Authors+Show Affiliations

Department of Neurosurgery, Unfallkrankenhaus Berlin, Berlin, Germany. ferass@al-zain.deNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

17923846

Citation

Al-Zain, F, et al. "Papilloedema in Association With Spinal Lipoma and Bilateral Chronic Subdural Bleeding." Spinal Cord, vol. 46, no. 5, 2008, pp. 392-4.
Al-Zain F, Gräwe A, Meier U. Papilloedema in association with spinal lipoma and bilateral chronic subdural bleeding. Spinal Cord. 2008;46(5):392-4.
Al-Zain, F., Gräwe, A., & Meier, U. (2008). Papilloedema in association with spinal lipoma and bilateral chronic subdural bleeding. Spinal Cord, 46(5), 392-4.
Al-Zain F, Gräwe A, Meier U. Papilloedema in Association With Spinal Lipoma and Bilateral Chronic Subdural Bleeding. Spinal Cord. 2008;46(5):392-4. PubMed PMID: 17923846.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Papilloedema in association with spinal lipoma and bilateral chronic subdural bleeding. AU - Al-Zain,F, AU - Gräwe,A, AU - Meier,U, Y1 - 2007/10/09/ PY - 2007/10/10/pubmed PY - 2008/7/30/medline PY - 2007/10/10/entrez SP - 392 EP - 4 JF - Spinal cord JO - Spinal Cord VL - 46 IS - 5 N2 - STUDY DESIGN: A case report describing a patient presenting with papilloedema, headache and saddle hypoesthesia caused by a lumbo-sacral intraspinal extradural lipoma in the presence of a bilateral chronic subdural haematoma (cSDH). OBJECTIVE: The aim of this report is to discuss the pathophysiology of papilloedema in spinal tumours and the effect of the cSDH on the development of papilloedema. A search of the Medline database yielded no case reports describing papilloedema arising from spinal extradural lipoma in the presence of intracranial cSDH. SETTING: Department of Neurosurgery, Unfallkrankenhaus Berlin, Berlin, Germany. CASE REPORT: We report a clinical case of cauda equina compression due to an extradural lipoma presenting with papilloedema. Cranial computer tomography (CT-scan) additionally revealed a thin, bilateral cSDH. The patient underwent surgical excision of the lipoma subsequent to an L5-S3 laminectomy. On duratomy, a membranous thrombus formation was discovered between the nerve filaments. The patient experienced clinical improvement with regression of his neurological symptoms. Histological findings confirmed the diagnosis of lipoma and intradural thrombus. CONCLUSION: Spinal tumours may cause complex cerebrospinal fluid (CSF) dynamic and resorptive changes. These changes are mechanical, physiological or combined in their effect. Patients with papilloedema or increased intracranial pressure should be carefully examined by clinical and neuro-radiological means for cranial and spinal pathologies. The treatment of the primary cause might save the patient a series of unnecessary procedures. SN - 1362-4393 UR - https://www.unboundmedicine.com/medline/citation/17923846/Papilloedema_in_association_with_spinal_lipoma_and_bilateral_chronic_subdural_bleeding_ L2 - http://dx.doi.org/10.1038/sj.sc.3102128 DB - PRIME DP - Unbound Medicine ER -