Case Report
Spinal Cord (2008) 46, 392–394; doi:10.1038/sj.sc.3102128; published online 9 October 2007
Papilloedema in association with spinal lipoma and bilateral chronic subdural bleeding
F Al-Zain1, A Gräwe1 and U Meier1
1Department of Neurosurgery, Unfallkrankenhaus Berlin, Berlin, Germany
Correspondence: Dr F Al-Zain, Department of Neurosurgery, Unfallkrankenhaus Berlin, Warener Strasse 7, Berlin D-12683, Germany. E-mail: ferass@al-zain.de
Received 18 April 2007; Revised 21 August 2007; Accepted 26 August 2007; Published online 9 October 2007.
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.
Keywords:
papilloedema, spinal tumours, chronic subdural haematoma
MORE ARTICLES LIKE THIS
These links to content published by NPG are automatically generated
RESEARCH
Papilloedema in association with spinal lipoma and bilateral chronic subdural bleeding
Spinal Cord Correspondence
Spinal Cord Correspondence
Adult onset tethered cord syndrome associated with intradural dermoid cyst. A case report
Spinal Cord Correspondence
Spinal extradural meningeal cyst with spinal stenosis
Spinal Cord Correspondence
Spinal subdural haematoma: how relevant is the INR?
Spinal Cord Correspondence
