Board Certified Neurosurgeon Brain & Spine Care 860-889-9035
Mark Hornyak, MDBoard Certified Neurosurgeon
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Spine / Tumor Case

Spinal meningioma (C2)

71 yo woman presents with 10 months of progressive weakness of arms and legs. Started with difficulty walking and has progressed to the point that she needs significant assistance to walk. She also reports difficulty with voiding. Examination reveals severe left-sided weakness most pronounced in left hand and hip muscles. She is hyper-reflexic.

Description

71 yo woman presents with 10 months of progressive weakness of arms and legs. Started with difficulty walking and has progressed to the point that she needs significant assistance to walk. She also reports difficulty with voiding.
Examination reveals severe left-sided weakness most pronounced in left hand and hip muscles. She is hyper-reflexic.

Gallery

Images

Figure 1Sagittal MRI images (T2, T1, and T1 with contrast; left-to-right) showing a tumor (red arrow) behind the spinal cord at the level of C2. It enhances brightly with the administration of contrast.
Figure 2Axial MRI images (T2, T1, and T1 with contrast; left-to-right) showing a tumor (red arrow)
Figure 3Sagittal (left) and axial (right) CT scan images showing the bony anatomy of the patient. Degenerative changes are notes, but the tumor is not visualized on these images.
Figure 4Axial CT scan images showing soft tissue including the tumor (red arrow).
Figure 5Midsagittal images from two brain MRI’s. The left images is from a recent MRI, and the right is from 12 years prior. Note the large tumor on the new MRI and the hint of a small lesion on the MR image on the right.
Figure 6Intraoperative photo showing the covering of the spinal cord, the dura mater. The bone (lamina) over the dura has been removed. The dura has a normal appearance on its outer surface. Orientation: this is the back of the patient with the head to the left of the image and the legs to the right.
Figure 7Intraoperative photo showing the tumor and the spinal cord. The covering of the spinal cord has been opened. The blue arrow points to the tumor which is on the left of the image. The spinal cord is to the right of the arrow and is covered by a translucent membrane, the arachnoid mater.
Figure 8Intraoperative photo showing microdissection of the tumor from the spinal cord. The tumor is being retracted to the right, exposing many small bands of tissue (arrow) connecting the tumor to the spinal cord on the left.
Figure 9Intraoperative photo showing the dorsal surface (back side) of the spinal cord after the tumor has been resected.
Figure 10Intraoperative photo showing the
Figure 11Postoperative sagittal MRI images (T2, T1, and T1 with contrast; left-to-right) showing postop changes without residual tumor 3 months after her surgery. Compare with preop
Figure 12Axial MRI images (T2, T1, and T1 with contrast; left-to-right) showing postop changes without residual tumor 3 months after her surgery. Compare with

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