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ISSN: 2637-6628

Online Journal of Neurology and Brain Disorders

Case Report(ISSN: 2637-6628)

Cranio-Cervical Junction Meningioma: A Rare Case Report Volume 4 - Issue 5

Sukriti Das1*, Asit Chandra Sarker1, Dipankar Ghosh1, Kanji Fatema Ishrat Zahan1, Mohammed Shamsul Islam Khan1, Akhlaque Hossain Khan2 and Bipin Chaurasia3

  • 1Department of Neurosurgery, Dhaka Medical College & Hospital, Bangladesh
  • 2Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University, Bangladesh
  • 3Department of Neurosurgery, Tarai Hospital and research centre, Birgunj, Nepal

Received: November 06, 2020;   Published: November 30, 2020

Corresponding author: Sukriti Das, Associate Professor, Department of Neurosurgery, Dhaka Medical College & Hospital, , Dhaka, Bangladesh

DOI: 10.32474/OJNBD.2020.04.000198

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Abstract

Background: Meningioma is a benign and slowly growing intradural extramedullary spinal cord tumor. It arises from the arachnoid cap cell of the meninges. Meningioma of the cranio-cervical junction is a rare and unique diagnosis of about 1.8-3.2% of all meningiomas. These tumors usually grow slowly and develop symptoms gradually but, sometimes with sudden onset of quadriplegia. The lesions are usually very large at the time of diagnosis. Post-surgical tumor recurrence is high due to failure of complete removal of the tumor (Simpson grade-I) as critical vascular structures, brainstem and cranial nerves are close to it.

Case Report: We presented a case of a cranio-cervical junction meningioma of a 45-year-old female who presented with neck pain with headache and gradual weakness of all 4 limbs that made her unable to walk without support and bed-ridden gradually. She also developed urinary incontinence and was catheterized. On examination, the patient was conscious and alert, muscle power was of MRC grade 0/5 in all groups of muscles in all 4 limbs. All deep tendon reflexes were exaggerated in both upper and lower limbs with positive Hoffmann sign bilaterally and bilateral planter extensor response. All modalities of sensations were diminished up to C4 vertebral level. MRI of cervical spine was obtained, and the diagnosis of cranio-cervical junction meningioma came out.

Conclusion: After complete surgical removal (Simpson grade I) of the tumor, post-operative ICU management is very vital. Extubation and recovery may need long time to return to normal life. So pre-operative counseling and post-operative ICU support is mandatory to operate cranio-cervical junction meningioma.

Keywords: Cranio-Cervical Junction; Meningioma; Intradural-Extramedullary; Simpson Grade; Gross Total Removal

Abstract| Introduction| Case Report| Discussion| Conclusion| References|

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