Surgical intervention for a pediatric isolated intramedullary spinal aneurysm

  • Masayoshi Morozumi
  • Shiro Imagama
  • Kei Ando
  • Kazuyoshi Kobayashi
  • Tetsuro Hida
  • Kenyu Ito
  • Mikito Tsushima
  • Akiyuki Matsumoto
  • Satoshi Tanaka
  • Masaaki Machino
  • Kyotaro Ota
  • Yoshihiro Nishida
  • Naoki Ishiguro
Case Report

Abstract

Purpose

To report the case of a pediatric patient with intramedullary spinal aneurysm.

Methods

A 9-year-old boy presented with low back pain and subsequent gait disturbance. He had no history of trauma. After admission, MRI revealed an intramedullary spinal cord mass lesion surrounded by hemorrhage at the cervical–thoracic junction. Initial treatment was started with intravenous methylprednisolone and bed rest. Neurological deficit disappeared under careful observation for a few months. Surgical intervention was applied for diagnosis and resection of the mass lesion to prevent recurrent hemorrhage.

Results

Intraoperative ultrasound sonography helped to diagnose the lesion as a spinal cord aneurysm, prior to midline myelotomy. Monitoring of transcranial muscle evoked potentials helped to avoid spinal cord damage during surgery. There has been no evidence of spinal aneurysm on MRI for 3 years after surgery and no neurological deterioration.

Conclusion

To our knowledge, this is a first report of an intramedullary spinal cord aneurysm at the cervical–thoracic junction in a pediatric patient. Careful observation after initial symptoms followed by surgical intervention was favorable in this case.

Keywords

Spinal aneurysm Pediatric Surgery MRI Ultrasound 

Abbreviations

MRI

Magnetic resonance imaging

TcMEP

Transcranial muscle evoked potential

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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Masayoshi Morozumi
    • 1
  • Shiro Imagama
    • 1
  • Kei Ando
    • 1
  • Kazuyoshi Kobayashi
    • 1
  • Tetsuro Hida
    • 1
  • Kenyu Ito
    • 1
  • Mikito Tsushima
    • 1
  • Akiyuki Matsumoto
    • 1
  • Satoshi Tanaka
    • 1
  • Masaaki Machino
    • 1
  • Kyotaro Ota
    • 1
  • Yoshihiro Nishida
    • 1
  • Naoki Ishiguro
    • 1
  1. 1.Department of Orthopaedic SurgeryNagoya University Graduate School of MedicineNagoyaJapan

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