Surgical Neurology International, 2021 · DOI: 10.25259/SNI_856_2020 · Published: May 31, 2021
A young male patient was admitted to the emergency room after a fall, experiencing right-sided limb trauma and left inferior limb motor weakness. Initial CT scans showed no spinal trauma, but the patient later developed severe paraparesis. Subsequent MRI revealed a lesion compressing the spinal cord, initially suspected to be a hemorrhage. Surgery revealed a large extramedullary lesion, which was completely removed and identified as a schwannoma. The patient showed neurological improvement after surgery and motor rehabilitation, eventually regaining normal muscle strength in the inferior limbs. The case highlights the difficulty in early diagnosis of thoracic spine schwannomas and suggests that such tumors should be considered in the differential diagnosis of patients with acute neurological deficits following trauma, even in the absence of visible traumatic signs on initial imaging.
Clinicians should consider spinal tumors, such as schwannomas, in the differential diagnosis of patients presenting with acute neurological deficits following trauma, even without visible traumatic lesions on initial imaging.
Early decompressive surgery can lead to significant neurological improvement and recovery of motor function in patients with spinal schwannomas presenting with acute neurological deficits after trauma.
In patients with neurological deficits after trauma where initial CT scans are negative for bony lesions, MRI should be considered to evaluate for soft tissue abnormalities such as tumors or hemorrhages.