2 case reports of spinal meningioma

2 case reports of spinal meningioma by Dr. Devdutta, Dr. S. Ichnalkar, Dr. R.M. Kulkarni

Transcript

1. 2 case reports of spinal meningioma DR. DEVDUTTA, DR. S. ICHNALKAR, DR. R.M. KULKARNI
2. Case 1  32 yr old/f came with c/o : tingling, numbness, unable to walk with loss of power in left lower limb with decrease in tone and reflexes.  G/E : conscious; cooperative; oriented; vitals stable  CNS: GCS: 15/15; power: 3/5 in both lower limbs; plantars normal .  MRI spine: a focal well defined altered signal intensity intradural extramedullary mass lesion in the spinal canal extending from the level of D2-D3 disc level inferiorly upto mid part of the body of D4 level posteriorly. The mass is compressing the spinal cord and displacing it anteriorly, cord edema is seen, i.e. meningioma.
3.  Management: Surgical: D1 to D6 laminectomy and total excision of intradural extramedullary mass. Histopathological report: confirmed it as meningioma Post op: Physiotherapy and ambulation.  Prognosis: gradual recovery of previously lost neurological function and discharged on day 10 of admission.
4. Case 2  A 52 yr old/m came with c/o tingling, numbness, unable to walk, unable to lift both legs since 2 months with bladder incontinence since 15 days.  G/E: conscious, cooperative, oriented.  CNS: GCS: 15/15; power in both lower limbs: 2/5; tone reduced; plantars normal.  MRI: a well defined ovoid focal intradural extramedullary nodular lesion along left postero-lateral aspect at level of D2 vertebra displacing and compressing upper lateral cord, most likely to be a meningioma.
5.  Management: Surgical: D1, D2, D3 laminectomy and total excision of intradural extramedullary mass. Histopathology report: diagnosed as meningioma Post op: Physiotherapy and ambulation. Prognosis: gradual recovery of previously lost neurological function and discharged on day 12 of admission.
6. Take home message!!! “Completeness of the surgical removal is the single most important prognostic factor.”