Document Detail

Cervical extramedullary mass lesion due to chronic CSF overshunting: case report and literature review.
MedLine Citation:
PMID:  19308427     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Several emerging clinical and neuroimaging conditions due to CSF intracranial hypotension have been documented. Recently, a few instances of a severe form of cervical myelopathy due to CSF overshunting have also been reported. Patients with this type of cervical myelopathy usually evolve with marked clinical manifestations of spinal cord involvement. MATERIALS AND METHODS: In this article, we report a 20-year-old girl, previously given a ventriculoperitoneal shunt at age 6 years, who presented with neck pain after a whiplash injury. RESULTS AND DISCUSSION: Magnetic resonance imaging revealed a cervical extramedullary mass that mimicked a cervical extradural hematoma. Further neuroimaging studies demonstrated that it corresponded to an engorged cervical epidural venous plexus that we attributed to chronic CSF overdrainage. After expectant management, the patient experienced a total recovery of her symptoms. To our knowledge, this is the first report of this condition occurring in an asymptomatic patient. Our aim in reporting this patient is twofold: (1) to warn the clinician about these neuroimaging findings that may mimic a cervical extradural hematoma and (2) to illustrate that engorged cervical epidural plexus may occur in patients in the absence of clinical manifestations of myelopathy. Recognition of this entity is important to distinguish it from a mass lesion in which a surgical intervention might be indicated.
Juan F Martínez-Lage; Fernando Alarcón; Raúl Alfaro; Antonio Ruíz-Espejo; Antonio López López-Guerrero; José Hernández-Abenza
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Publication Detail:
Type:  Case Reports; Journal Article; Review     Date:  2009-03-24
Journal Detail:
Title:  Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery     Volume:  25     ISSN:  1433-0350     ISO Abbreviation:  Childs Nerv Syst     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-05     Completed Date:  2009-08-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8503227     Medline TA:  Childs Nerv Syst     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  895-8     Citation Subset:  IM    
Regional Service of Neurosurgery, Virgen de la Arrixaca University Hospital, El Palmar, E-30120, Murcia, Spain.
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MeSH Terms
Brain / pathology,  radiography,  surgery
Cerebrospinal Fluid Shunts / adverse effects*
Cervical Vertebrae
Diagnosis, Differential
Hematoma, Epidural, Cranial / diagnosis
Magnetic Resonance Imaging
Neck Pain / etiology
Spinal Cord Diseases / etiology*,  pathology
Spine / blood supply,  pathology,  radiography
Tomography, X-Ray Computed
Treatment Outcome
Whiplash Injuries / complications
Young Adult

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