Acute spinal injury associated with benign spinal cord tumor in pregnant woman: case report

A.Yu. Lubnin, N.A. Konovalov, A.V. Shmigelskiy, T.F. Tabassaranskiy, K.N. Avhlediany, I.A. Savin, R.A. Onoprienko, M.A. Martynova

Federal State Budgetary Scientific Institution «Scientific and Research Institute of Neurosurgery named by an acad. N.N. Burdenko», Moscow

For citation: Lubnin AYu, Konovalov NA, Shmigelskiy AV et al. Acute spinal injury associated with benign spinal cord tumor in pregnant woman: case report. Intensive Care Herald. 2016;1:50–57.


A case of acute circulatory disorder of the spinal cord (level C3-C5) in pregnant woman (20 weeks) due to the bleeding of the endodermal cyst is reported. There weren’t any regression in neurologic symptoms despite the radical removal of the mentioned cyst and decompression of the spinal cord, probably due to the delayed operation. The patient died three months after the event due to infectious complications, remaining tetraplegic. Pregnancy was maintained and prolonged till 29 weeks. Pre-term ceasarean section was performed. Patient’s condition remained severe due to subependymal hemorrhage.

Keywords: acute disorder of the spinal blood circulation, endodermal cyst, pregnant woman, surgical removal, outcomes.


Литература

  1. Евзиков Г.Ю., Крылов В.В., Яхно Н.Н. Хирургическое лечение внутримозговых спинальных опухолей.- ГЭОТАР-Медиа, 2006.- 120 с. ISBN: 5-9704-0109-9.
  2. Гринберг М.С. Внутримозговые кровоизлияния у новорожденных. В кн.: Нейрохирургия.- Москва, 2010. «МЕДпресс-информ», пер. с англ., 5е издание, с. 891-895.
  3. Шевелев И.Н., Коновалов Н.А., Кушель Ю.В. и соавт. Диагностика и хирургическое лечение опухолей позвоночника и спинного мозга. // В кн. Современные технологии и клинические исследования в нейрохирургии. Под ред. А.Н. Коновалова.- 2012.- Т. 3.- Москва,- с. 131-149.
  4. Can A., Dos Santos Rubio E.J., Jasperse B. et al. Spinal neurenteric Cyst in association with Klippel-Feil syndrome: Case report and literature review.// World Neurosurg. 2015. V. 84 p. 592.e9 – 14. doi: 10.1016/j.wneu.2015.03.015.
  5. Chen M.M., Coakley F.V., Kaimal A., Laros R.K. Guidelines for computed tomography and magnetic resonance imaging use during pregnancy and lactation.// Obstet. Gynecol. 2008 V. 112 p. 333-340.
  6. Fehlings M.G., Perrin R.G. The role and timing of early decompression for cervical spinal cord injury: update with a review of recent clinical evidence.// Injury. 2005. V. 36 Suppl. 2 p. B13-B26.
  7. Fehlings M.G., Perrin R.G. The timing of surgical intervention in the treatment of spinal cord indjury: a systematic review of recent clinical evidence.// Spine. 2006. V. 31 Suppl. p. S28-S36.
  8. Friesbie J.H. Salt wasting, hypotension, polydipsia, and hyponatremia and the level of spinal cord injury.// Spinal Cord. 2007. V. 45 p. 563-568.
  9. Han I.H., Kuh S.U., Kim J.H. et al. Clinical approach and surgical strategy for spinal diseases in pregnant women.// SPINE. 2008. V. 33 p. E614-E619.
  10. Ito K., Aoyama T., Kiuchi T. et al. Ventral intradural endodermal cyst in the cervical spine treated with anterior corpectomy – case report.// Neurol. Med. Chir. 2011. V. 51 p. 863-866.
  11. La Rosa G., Conti A., Cardali S. et al. Does early decompression improve neurological outcome of spinal cord injured patients? Appraisal of the literature using a meta-analytical approach.// Spinal Cord. 2004. V. 42 p. 503-512.
  12. Moles A., Hamel О., Perret C. et al. Symptomatic vertebral hemangiomas during pregnancy. Report of 2 cases// J. Neurosurg. Spine. 2014. V. 20 p. 585-591.
  13. Pikis S., Cohen J.E., Rosenthal G. et al. Spinal meningeoma becoming symptomatic in the third trimester of pregnancy.// J. Clin. Neurosci. 2013. V. 20 p. 1797-1799.
  14. Shinozaki M., Morita A., Kamijo K. et al. Symptomatic T2 vertebral hemangioma in a pregnant woman treated by one stage combination surgery: Posterior stabilization and anterior subtotal tumor resection.// Neurol Med. Chir. 2010. V. 50 p. 674-677.
  15. Vijay K., Shetty A.P., Rajasekaran S. Symptomatic vertebral hemangioma in pregnancy treated antepartum. A case report with review of literature.// Eur. Spine J. 2008. V. 17 Suppl. 2 p. S299-S303. doi: 10.1007/s00586-008-0592-2.
  16. Wakao N., Imagama S., Ito Z. et al. A case of split notochord syndrome: an adult with a spinal endodermal cyst mimicking an intramedullary tumor// Neuropathology. 2011 V. 31 p. 626 – 631. doi: 10.1111/j.1440-1789.2011/01212.x.