Intradural extramedullary spinal tumor

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While intradural extramedullary spinal disease varies widely, identification of tumors in this location and their radiologic manifestations greatly facilitates narrowing of the diagnostic considerations.

Spinal meningioma and spinal schwannoma are the two most common intradural extramedullary spinal tumors, and both are associated with neurofibromatosis.

see Intradural extramedullary spinal tumor differential diagnosis.

1. Pain: The most common initial symptom, often localized or radicular, worsens at night or with Valsalva maneuvers.
2. Radiculopathy: Due to nerve root compression, causing dermatomal pain, paresthesia, or weakness.
3. Myelopathy: If the tumor compresses the spinal cord, leading to progressive weakness, spasticity, and sensory disturbances.

1. Weakness: Initially subtle, progressing to significant paresis or paralysis.
2. Hypoesthesia or Hyperesthesia: Segmental sensory loss or dysesthesia depending on the affected level.
3. Gait Ataxia: Common in cervical and thoracic lesions due to corticospinal tract involvement.
4. Bowel and Bladder Dysfunction: Especially with tumors in the thoracolumbar region causing sphincter disturbances.

1. Meningiomas: More common in middle-aged women, slow-growing, causing gradual myelopathy.
2. Schwannomas & Neurofibromas: Typically present with radicular pain, can be part of NF2 or sporadic.
3. Ependymomas (Myxopapillary in the filum terminale): Associated with cauda equina syndrome and lower extremity weakness.

1. Severe Motor Impairment: Progressive paraplegia or quadriplegia.
2. Loss of Reflexes: Depending on the level of compression (hyperreflexia if upper motor neuron, hyporeflexia if lower motor neuron).
3. Autonomic Dysfunction: Including erectile dysfunction and urinary retention.

Intradural extramedullary spinal tumor diagnosis.

Intradural extramedullary spinal tumor differential diagnosis

Intradural extramedullary spinal tumor case series.

Intradural extramedullary spinal tumor treatment.