PMC4533433_01
Preoperative neuro-images of our case. A: Head computed tomography (CT) shows large ventricles and a poor depiction of the cerebral sulcus. B: The mass lesion was enhanced with gadolinium. C: A CT myelogram shows a mass lesion blocking cerebrospinal fluid flow at the L1-2 level.
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F1
Computed tomography (CT) of the head revealed ventricular dilatation (Fig. 1A). Lumbar spinal magnetic resonance imaging (MRI) were conducted in order to examine the patient for normal pressure hydrocephalus (NPH), and the imaging demonstrated a well-demarcated intradural tumor in the cauda equina at the L1-L2 level (Fig. 1B). CT myelography revealed total blockage of the CSF by the tumor (Fig. 1C).
Intraoperative findings of our case. After opening of the dura, the tumor and a whitish arachnoid membrane were observed.
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F2
After a posterior L1-L2 laminectomy and a Th12 partial laminectomy, the dural sac was opened, and cloudy arachnoid membrane at the caudal side of the tumor was found (Fig. 2).
Pathological findings of our case. Mixed components of Antoni B (400x) (A) and Antoni A (400x) (B). No malignant cells were found in these specimens.
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F3
A histological examination of the tumor showed typical features of a benign neurinoma (Fig. 3A, B).
Postoperative neuroimages of our case. A: A computed tomography of the head shows a slight reduction in ventricular size and a clear depiction of the cerebral sulcus. B: Total removal of the tumor was confirmed by magnetic resonance imaging with gadolinium.
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F4
Total removal of the tumor was confirmed with CT and MRI (Fig. 4B). Three months after the surgery, a head CT showed reduction in ventricular size (Fig. 4A), and no other symptom of NPH was observed.