Intensive Mirror-Picture Neurofibromas of Complete Backbone Leading to Spastic Tetraplegia.
World Neurosurg. 2017 Dec;108:985.e7-985.e8
Authors: Bigder M, Szelemej P, Berrington N
Neurofibromatosis 1 (NF1) is related to elevated incidence of spinal tumors together with neurofibromas. The vast majority of NF1-associated backbone neurofibromas are asymptomatic; nevertheless, a minority of sufferers will expertise neurologic signs that may vary from delicate paresthesia, radiculopathy, myelopathy, and focal weak spot to quadriplegia in excessive circumstances. We current a 21-year-old male recognized with NF1 in infancy and adopted for a number of mirror-image neurofibromas involving the complete backbone. He was asymptomatic till age 14 when he developed neck ache and progressive tetraplegia with magnetic resonance imaging displaying extreme wire compression secondary to bilateral C2 neurofibromas. Emergent cervical decompression was carried out at C1-C3 together with debulking of bilateral neurofibromas. Postoperatively he regained full energy with no indicators of myelopathy a number of years postoperatively. This case demonstrates a dramatic neuroimaging discovering and emphasizes the potential for vital neurologic deterioration in beforehand asymptomatic NF1 sufferers, highlighting the necessity for long-term follow-up.
PMID: 28867317 [PubMed – indexed for MEDLINE]