Usanov E.I., Kirichenko K.N., Korshunov N.B.
(Polenov Research Neurosurgical Institute Raukhfus Minicipal Hospital N 19)
Male patient M., aged 7, was admitted to the Neurosurgical Department of Raukhfus Municipal Hospital N 19 in February 17, 2000 with complaints of weakness in upper and lower extremities. The disease onset was acute. Weakness in the upper and lower extremities developed on January 10, 2000 against a background of complete health. The patient was examined by specialists of the Research Institute of Children's Infections. Encephalitis was suspected. MRI examination, carried out on the 7 day of the patient's stay at the Institute, revealed neoplasm (1.2 x 2.0 x 2.4 cm) with extramedullary localization at the level of C2-C3. It spread along the anterior surface of the spinal cord and medulla oblongata. Subarachnoid spaces were blocked.
On admission there was tetraparesis of a mixed type, more marked in proximal parts of extremities. Evaluation of muscular strength revealed its reduction; the score was equal to 2. There were no sensation disorders. The functions of pelvic organs were normal.
The patient was operated in a sitting position (2.03.2000). Laminectomy of C1-C3, total removal of meningioma were performed (Prof. Usanov E.I.).The patient had fever during 10 days of a postoperative period; there was neutrophilic cytosis up to 3000/3. Use of antibiotics resulted in arrest of these phenomena. The patient was discharged on the 25 day after the operation. He walked and did not need any assistance.
To demonstrate possibility of total removal of tumors, localized on the anterior surface of the spinal cord and medulla oblongata in the area of the craniovertebral junction.