• Journal of Korean Neurosurgical Society
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• v.29 no.9
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• pp.1238-1242
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• 2000

Spinal schwannomas are usually extramedullary intradural tumors and their intramedullary localizations are thought to be extremely rare. A 60-year-old woman complaining spastic quadriparesis, voiding difficulty and dyspnea was admitted. Her cervical MRI revealed an intramedullary mass in the cervicomedullary junction with multiple cyst which extended from lower cervical to C3 spinal cord. The mass showed a low signal on T1WI, high signal on T2WI with an wall enhancement. The patient underwent a suboccipital craniectomy and C1-2 laminectomy and the cystic tumor was totally removed through a midline myelotomy. The tumor was proved as an intramedullary schwannoma by pathologic examination. The Intramedullary presence of a tumor arising from the cells of the nerve sheath is unusual, because the central nervous system fibers do not contain the Schwann cell. There have been several hypotheses, but none has been accepted universally. This rare tumor is considered as a curable benign neoplasm, and an accurate intraoperative diagnosis and surgically total removal are essential.

• The Korean Journal of Pain
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• v.31 no.4
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• pp.296-304
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• 2018

Epiduroscopy is defined as a percutaneous, minimally invasive endoscopic investigation of the epidural space. Periduroscopy is currently used mainly as a diagnostic tool to directly visualize epidural adhesions in patients with failed back surgery syndrome (FBSS), and as a therapeutic action in patients with low back pain by accurately administering drugs, releasing inflammation, washing the epidural space, and mechanically releasing the scars displayed. Considering epiduroscopy a minimally invasive technique should not lead to underestimating its potential complications. The purpose of this review is to summarize and explain the mechanisms of the side effects strictly related to the technique itself, leaving aside complications considered typical for any kind of extradural procedure (e.g. adverse reactions due to the administration of drugs or bleeding) and not fitting the usual concept of epiduroscopy for which the data on its real usefulness are still lacking. The most frequent complications and side effects of epiduroscopy can be summarized as non-persistent post-procedural low back and/or leg discomfort/pain, transient neurological symptoms (headache, hearing impairment, paresthesia), dural puncture with or without post dural puncture headache (PDPH), post-procedural visual impairment with retinal hemorrhage, encephalopathy resulting in rhabdomyolysis due to a dural tear, intradural cyst, as well as neurogenic bladder and seizures. We also report for first time, to our knowledge, a case of symptomatic pneumocephalus after epiduroscopy, and try to explain the reason for this event and the precautions to avoid this complication.