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The patient was seen at the operating room first time, complaining
of back pain with paraparesis below D2 more prominent at the right
side with almost drop right leg. Brown-Sequard syndrome was the
whole picture with severe paresis in the right and analgesia in the
left. MRI performed 11-March-2006 showing
huge intradural meningioma compressing the spinal cord at the level
of D1 and 2 from the right.
Laminectomy of D1-2 and partial of C7 was done and the dura was
opened. The tumor upper and lower poles were identified and the
arachnoid, including the anteriorly pushed right dentate ligament
were sharply bisected. So as to avoid trauma to the spinal cord the
right D3 root running over the tumor was also coagulated and
bisected, after what the spinal cord became relaxed and the tumor
start to shift to the right. The tumor matrix was coagulated and the
tumor was totally removed. After removal of the tumor, the matrix
was explored and meticulous cleaning of the remnants was performed.
Smooth postoperative recovery.
The patient in the immediate postoperative period and the next day
showed immediate improvement of her neurological deficit. She could
move with power of her right foot , but the sensory deficit still
the same. |
