European Spine Journal

, Volume 25, Supplement 1, pp 239–244 | Cite as

Surgical treatment for posttraumatic hemorrhage inside a filum terminale myxopapillary ependymoma: a case report and literature review

  • Daijiro MorimotoEmail author
  • Toyohiko Isu
  • Kyongsong Kim
  • Masanori Isobe
  • Tatsuro Takahashi
  • Yusuke Ishida
  • Hidehiro Takei
  • Akio Morita
Case Report



Symptoms of cauda equina syndrome due to ependymoma in the conus medullaris or filum terminale develop slowly. However, hemorrhagic change inside spinal tumors can induce acute neurologic decline. Here, we report a case of posttraumatic hemorrhage inside a filum terminale myxopapillary ependymoma presenting as acute neurologic decline, which had a positive prognosis after surgical resection.


A 28-year-old man presented with buttock pain, sensory disturbance, and motor weakness of bilateral lower extremities after falling on ice during smelt fishing. Magnetic resonance imaging demonstrated a mixed-intensity hemorrhagic intradural mass extending from L1 to L2.


The patient underwent emergent surgical decompression and resection. Pathologic examination revealed a myxopapillary ependymoma with intratumoral hemorrhage. After surgery, the patient demonstrated gradual improvement in neurologic deficits and no tumor recurrence.


This is the first case of a filum terminale myxopapillary ependymoma with an acute neurologic decline after injury. Early diagnosis and treatment are associated with favorable outcomes.


Hemorrhage Cauda equina Ependymoma Injury 



We would like to thank Editage ( for English language editing.

Compliance with ethical standards

Conflict of interest

The authors report no conflicts of interest concerning the materials or methods used in this study or the findings specified in this paper.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Daijiro Morimoto
    • 1
    • 5
    Email author
  • Toyohiko Isu
    • 1
  • Kyongsong Kim
    • 2
  • Masanori Isobe
    • 1
  • Tatsuro Takahashi
    • 3
  • Yusuke Ishida
    • 3
  • Hidehiro Takei
    • 4
  • Akio Morita
    • 5
  1. 1.Department of NeurosurgeryKushiro Rosai HospitalHokkaidoJapan
  2. 2.Department of NeurosurgeryNippon Medical School Chiba Hokuso HospitalChibaJapan
  3. 3.Department of PathologyKushiro Rosai HospitalHokkaidoJapan
  4. 4.Department of Diagnostic PathologyAsahikawa Medical UniversityHokkaidoJapan
  5. 5.Department of Neurological SurgeryNippon Medical SchoolTokyoJapan

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