Acute presentations of intradural lipomas: case reports and a review of the literature

BMC Neurology
Luca MassimiMassimo Caldarelli

Abstract

Lumbosacral lipomas (LLs) may remain asymptomatic or lead to progressive neurological deterioration. However, sudden neurological deterioration is a rare and severe event. Herein, we report rare occurrences of sudden clinical deterioration in two previously asymptomatic children harbouring intradural LLs without dermal sinus tracts or signs of occult dysraphism. A review of the pertinent literature is also included. One child exhibited acute deterioration because of an epidural abscess associated with a filar lipoma without a sinus tract (probably caused by haematogenous spreading from a respiratory tract multiple infection), and the other child exhibited acute deterioration because of a very large, holocord syringomyelia-like cyst associated with a small conus lipoma. Both patients were 4 years old. In case #2, a previously undetected, severe tethered cord (conus at the S3-S4 level) was also present. A complete recovery was attained after an urgent surgical operation in both cases (in addition to targeted antibiotic therapy in case #1). All cases of deterioration in the literature were caused by abscess formation in dermal sinus tracts. Prophylactic surgery may be indicated even in asymptomatic children that have tethered cord...Continue Reading

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Citations

Apr 16, 2020·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Pietro SpennatoGiuseppe Cinalli

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Methods Mentioned

BETA
surgical resection
prophylactic surgery

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