Chordoid meningioma: report of 5 cases and review of the literature.

Chordoid meningioma is a rare, more aggressive subtype of meningioma. This study documents the histological, radiological and clinical features of seven tumours in five patients among 131 meningioma patients who were treated in the Department of Neurosurgery at Istanbul Medipol University between 2014 and 2019. There were two males and three females. All tumours were supratentorial. Surgical Simpson grade II resection was achieved in two cases, grade I in one and grade IV in two. One case relapsed and underwent further surgeries and adjuvant treatment. The chances of survival without recurrence after the Simpson grade I-II resection are high but close follow-up is recommended particularly if grade I cannot be achieved.

Use of the bovine pericardial patch and fibrin sealant in meningomyelocele closure.

BACKGROUND: Meningomyelocele is the most common and complex birth defect of the central nervous system. The operative principle of meningomyelocele repair consists of consecutive separate closures of the neural placode, dura mater, lumbar fascia, subcutaneous layer, and skin. While the neurosurgical techniques for the closure of the neural placode and dura mater have been well accepted, the most appropriate soft tissue closure technique has not yet been applied. METHODS: This study reviews a case series of eight meningomyelocele patients treated with the bovine pericardial patch and fibrin sealant. Following the reconstruction of the neural placode and the closure of the dura mater, soft tissue coverage was achieved using the bovine pericardial patch and fibrin sealant. RESULTS: In this series of eight patients, stable coverage was achieved with the application of a bovine pericardial patch and fibrin sealant technique. After the operations, none of the possible complications such as cerebrospinal fluid leak, seroma, hematoma, skin necrosis, deep or superficial infection, and wound breakdown was observed. CONCLUSIONS: The usage of the bovine pericardial patch and fibrin sealant technique at the fascial level-between the dural sac and the skin-provides adequate soft tissue coverage in meningomyelocele repair surgery.

Attenuation of cerebral vasospasm and secondary injury by testosterone following experimental subarachnoid hemorrhage in rabbit.

BACKGROUND: The vasodilatator effects of testosterone have been widely studied and demonstrated. Based on previous studies of these vasodilatatory activities, we hypothesized that testosterone might have potential effects on subarachnoid hemorrhage-induced cerebral vasospasm. METHODS: Thirty-two adult male New Zealand white rabbits were randomly divided into four groups of eight rabbits in each group: group 1 (control); group 2 (subarachnoid hemorrhage); group 3 (subarachnoid hemorrhage + vehicle); and group 4 (subarachnoid hemorrhage + testosterone). Testosterone (15 mg/kg, intraperitoneally) was administered 5 min after the intracisternal blood injection and continued for 72 h once per day in the same dose for group 4. Animals were killed 72 h after subarachnoid hemorrhage. Basilar artery cross-sectional areas, arterial wall thicknesses, and hippocampal degeneration scores were evaluated in all groups. RESULTS: Intraperitoneal administration of testosterone was found to attenuate cerebral vasospasm and provide neuroprotection after subarachnoid hemorrhage in rabbits. Testosterone treatment was determined to be effective at increasing the luminal area and reducing the wall thickness of the basilar artery. CONCLUSIONS: Our findings show that testosterone has some preventive effects on SAH-induced vasospasm and secondary neuronal injury in rabbits. We propose that the vasodilatatory activity of testosterone is due to its effects on inhibiting calcium channels, activating potassium channels, augmenting nitric oxide synthesis, and inhibiting oxidant stress and inflammation.

Clinical outcome of adult choroid plexus tumors: retrospective analysis of a single institute.

BACKGROUND: Choroid plexus tumors are rare brain tumors with clinical features that vary according to the histological grade. We reviewed the treatment outcomes of 15 adult patients with choroid plexus tumors, focusing on surgical outcomes and current therapeutic strategies. METHOD: Patient demographic and clinical characteristics, operative findings, adjuvant therapies, disease progression and survival rates were reviewed. RESULTS: The median age at diagnosis was 33.7 ± 10 years (19-59 years) for patients with choroid plexus tumors. Postoperative chemotherapy was given to 26.7 % of patients, and 13.3 % of patients received radiotherapy. The Ki-67 labeling index and mitotic index increased at higher histological grades. All of the choroid plexus papilloma and atypical choroid plexus papilloma patients have survived. The overall survival rate of patients with choroid plexus carcinoma was 50 % in the first year, but none of the patients survived to the second year. Five patients underwent permanent cerebrospinal fluid diversion surgery because of hydrocephalus or subdural effusion. CONCLUSIONS: Choroid plexus papilloma and atypical choroid plexus papilloma patients can be treated with complete surgical resection. Choroid plexus carcinoma has a poor prognosis, and aggressive multi-modal treatments are generally needed for treatment. Chemotherapy and radiotherapy are important adjuvant therapies for choroid plexus carcinoma. If hydrocephalus and/or subdural effusion occur, permanent cerebrospinal fluid (CSF) diversion should be added to the therapeutic strategy.

The comparative effects of recombinant human erythropoietin and darbepoetin-alpha on cerebral vasospasm following experimental subarachnoid hemorrhage in the rabbit.

BACKGROUND: Darbepoetin alpha is a hypersialylated analogue of erythropoietin effective for activating erythropoietin-receptors. This study investigated the vasodilator and neuroprotective effects of darbepoetin alpha on an experimental subarachnoid hemorrhage model and compared it with erythropoietin. METHODS: Forty adult male New Zealand white rabbits were randomly divided into four groups of ten rabbits each: group 1 (control), group 2 (subarachnoid hemorrhage), group 3 (erythropoietin), and group 4 (darbepoetin alpha). Recombinant human erythropoietin was administered at a dose of 1,000 U/kg intraperitoneally after the induction of subarachnoid hemorrhage and continued every 8 h up to 72 h. Darbepoetin alpha was administered at a single intraperitoneal dose of 30 µg/kg. Animals were killed 72 h after subarachnoid hemorrhage. Basilar artery cross-sectional areas, arterial wall thicknesses, hippocampal degeneration scores and biochemical analyses were measured in all groups. RESULTS: Both erythropoietin and darbepoetin alpha treatments were found to attenuate cerebral vasospasm and provide neuroprotection after subarachnoid hemorrhage in rabbits. Darbepoetin alpha revealed better morphometric and histopathological results than erythropoietin among experimental subarachnoid hemorrhage-induced vasospasm. CONCLUSIONS: Our findings, for the first time, showed that darbepoetin alpha can prevent vasospasm and provides neuroprotection following experimental subarachnoid hemorrhage. Moreover, darbepoetin alpha showed better results when compared with erythropoietin.

Neurosurgery training camp for medical student: experience of the Turkish neurosugery academy and Bursa Uludag University.

Introduction: To highlight the importance of hands-on experiences and mentorship in shaping the future workforce of specialized medical professionals via a Neurosurgery Training Camp. Methods: Responses of the questionnaire regarding the Neurosurgery Training Camp organized by Bursa Uludag University's Faculty of Medicine and the Turkish Neurosurgery Academy were reviewed retrospectively. A one-day program was organized to introduce neurosurgery to medical students. During the camp, the students participated in interactive presentations delivered by faculty members, had lunch together, became acquainted with neurosurgical tools and technologies, and performed interventions. With pre and postworkshop questionnaire, student's expectations and thoughts about camp was evaluated. Results: Forty-one students from 10 medical schools, spanning every year of study, attended the camp. Approximately 39% of the attendees (n = 16) were women and 61% (n = 25) were men. The post-workshop survey results demonstrated that 73% of the students (n = 30) were inclined to pursue a career in neurosurgery after the camp, 21.9% (n = 9) remained undecided, and 4.8% (n = 2) chose not to pursue neurosurgery. Feedback from the post-workshop questionnaire highlighted that all students perceived the camp as beneficial in providing insights into their future careers and aiding in making a decision regarding their career paths. Discussion: The neurosurgical training camp effectively inspired and educated medical students about the discipline of neurosurgery. Furthermore, the camp effectively altered the career aspirations and perceptions of neurosurgery among the participating students.

The protective effect of 2-mercaptoethane sulfonate (MESNA) against traumatic brain injury in rats.

BACKGROUND: The agent, 2-mercaptoethane sulfonate (MESNA), is a synthetic small molecule, widely used as a systemic protective agent against chemotherapy toxicity, but is primarily used to reduce hemorrhagic cystitis induced by cyclophosphamide. Because MESNA has potential antioxidant and cytoprotective effects, so we hypothesized that MESNA may protect the brain against traumatic injury. METHOD: Thirty-two rats were randomized into four groups of eight animals each; Group 1 (sham), Group 2 (trauma), Group 3 (150 mg/kg MESNA), Group 4 (30 mg/kg methylprednisolone). Only skin incision was performed in the sham group. In all the other groups, the traumatic brain injury model was created by an object weighing 450 g falling freely from a height of 70 cm through a copper tube on to the metal disc over the skull. The drugs were administered immediately after the injury. The animals were killed 24 h later. Brain tissues were extracted for analysis, where levels of tissue malondialdehyde, caspase-3, glutathione peroxidase, superoxide dismutase, nitric oxide, nitric oxide synthetase and xanthine oxidase were analyzed. Also, histopathological evaluation of the tissues was performed. RESULTS: After head trauma, tissue malondialdehyde levels increased; these levels were significantly decreased by MESNA administration. Caspase-3 levels were increased after trauma, but no effect of MESNA was determined in caspase-3 activity. Following trauma, both glutathione peroxidase and superoxide dismutase levels were decreased; MESNA increased the activity of both these antioxidant enzymes. Also, after trauma, nitric oxide, nitric oxide synthetase and xanthine oxidase levels were increased; administration of MESNA significantly decreased the levels of nitric oxide, nitric oxide synthetase and xanthine oxidase, promising an antioxidant activity. Histopathological analysis showed that MESNA protected the brain tissues well from injury. CONCLUSIONS: Although further studies considering different dose regimens and time intervals are required, MESNA was shown to be at least as effective as methylprednisolone in the traumatic brain injury model.

The surgical outcome of traumatic extra-axial hematomas causing brain herniation in children.

AIM: The aim of this study was to assess the surgical outcome and prognostic importance of clinical and radiological data from children operated on under emergency conditions due to an extra-axial hematoma causing brain herniation. METHODS: This retrospective study included 25 children operated on due to herniated traumatic extra-axial hematomas from January 2000 to December 2010. RESULTS: Of those 25 children, 17 (68%) were diagnosed with subdural hematoma (SDH), 7 (28%) with epidural hematoma (EDH) and only 1 patient (4%) suffered from both SDH and EDH. Overall mortality from a herniated extra-axial hematoma was 44%. The mortality rate for herniated SDH patients was 52.9%, and only 1 patient died from a herniated EDH (14.2%). Low Glasgow coma scale scores at admission, high postoperative intracranial pressure (ICP) values, longer intervals from trauma to surgery, longer durations of brain herniation, the presence of intraoperative brain swelling, larger and thicker hematomas and more displacement of the midline structures and obliteration of the basal cisterns were all correlated with mortality and an unfavorable outcome. CONCLUSIONS: Brain herniation is a serious consequence of traumatic extra-axial hematomas in children, and approximately one third of these patients have the potential for a favorable outcome. We recommend postoperative ICP monitoring to predict outcome and early decompressive surgery when possible for promising results.

Effects of Topically Applied Contractubex® on Epidural Fibrosis and Axonal Regeneration in Injured Rat Sciatic Nerve.

AIM: To investigate the effects of Contractubex® (Cx) on peripheral nerve regeneration and scar formation. MATERIAL AND METHODS: A surgical procedure involving sciatic nerve incision in 24 adult male Sprague-Dawley rats followed by epineural suturing was performed. In weeks 4 and 12 following surgery, macroscopic, histological, functional, and electromyographic examinations of the sciatic nerve were conducted. RESULTS: No significant difference was found between the Cx group and the control group in terms of sciatic function index (SFI) and distal latency results at week 4 (p > 0.05). However, significant improvements in the Cx group were observed in SFI amplitudes and nerve action potentials at week 12 (p < 0.001 and p < 0.001, respectively). Significant improvements were found in the amplitudes of nerve action potentials in the treatment group after weeks 4 and 12 (p < 0.05 and p < 0.001, respectively). Macroscopically and histopathologically, epidural fibrosis decreased (p < 0.05 and p < 0.001, respectively). For both measurement times, the treatment group had significantly higher numbers of axons (week 4, p < 0.05; week 12, p < 0.001), and the treatment group had better results regarding its axon area (weeks 4 and 12, p < 0.001) and myelin thickness (weeks 4 and 12, p < 0.05). CONCLUSION: Cx, which is applied topically in peripheral nerve injury, affects axonal regeneration and axonal maturation positively and reduces the functional loss.

Flow Diversion Therapy of Remnant and Recurrent Intracranial Aneurysms Treated Surgically.

AIM: To evaluate the safety and efficacy of flow diverter stents (FDSs) for treating remnant or recurrent intracranial aneurysms that were treated surgically. MATERIAL AND METHODS: The patients who were treated with FDSs due to remnant or recurrent intracranial aneurysms after microsurgery were included in the study. The patients' demographics, treatment histories, aneurysm features, complications associated with flow diversion, and neurological and angiographic follow-up findings were evaluated. RESULTS: Twenty patients (eight males) with 20 aneurysms were included in the study. Of 20 aneurysms, 18 (90%) were in the anterior, and two (10%) were in the posterior circulation. The initial treatment methods were clipping in 17 (85%) and wrapping in three (15%) aneurysms. The endovascular procedure was successful in all patients. In three patients (15%), periprocedural and postprocedural complications were encountered. No hemorrhagic complications were detected on cone-beam computed tomography. One patient with a basilary aneurysm died because of brain stem ischemia. The total morbimortality was 5%. The mean length of follow-up was 13.7 ± 7.3 months in 18 patients. The first angiographic follow-up (3-6 months) revealed the complete occlusion in 7 of 11 aneurysms (63.6%). By contrast, 16 aneurysms (94.1%) were occluded at the last angiographic follow-up, one aneurysm (5.9%) was still filling. CONCLUSION: An FDS seems effective, safe, and extremely attractive in treating remnant and recurrent intracranial aneurysms treated surgically.

Methothrexate attenuates early neutrophil infiltration and the associated lipid peroxidation in the injured spinal cord but does not induce neurotoxicity in the uninjured spinal cord in rats.

BACKGROUND: The goal of most acute therapies for spinal cord injury (SCI) in humans include attenuation of the early inflammatory response and may limit the extent of tissue injury and the consequent disability. OBJECTIVE: The purpose of this study was to investigate the early effects of methothrexate (MTX) treatment on myeloperoxidase (MPO) activity, malondialdehyde (MDA) level, and ultrastructural findings in the injured and uninjured spinal cords of rats. The effects of MTX treatment were also compared with methylprednisolone sodium succinate (MPSS) treatment. METHODS: Wistar rats were divided into seven groups: control; trauma alone (50 g/cm weight drop trauma); SCI + MPSS (30 mg/kg); SCI + low-dose (0.5 mg/kg) MTX (LDMTX); SCI + higher-dose (1 mg/kg) MTX (HDMTX); non-trauma + LDMTX; non-trauma + HDMTX. RESULTS: Administration of MTX and MPSS treatments significantly decreased MPO activity (p < 0.05) and MDA level (p < 0.05) in the first 24 h. The MTX treatments, particularly HDMTX, were more effective than MPSS in reducing MPO activity, and MTX treatments were also more effective than MPSS in reducing MDA level (p < 0.05). The MTX treatment was more protective on large- and medium-diameter myelinated axons in minimizing ultrastructural changes in the spinal-cord-injured rats, but did not induce neurotoxicity in normal spinal cord. CONCLUSION: The results of this study indicate that MTX treatment has a beneficial effect by reducing early neutrophil infiltration and the associated lipid peroxidation, and has significantly protective effects on the injured spinal cord tissue in the first 24 h after SCI. Given the anti-inflammatory properties of MTX, a single dose of MTX a week is used for non-neoplastic disease in humans, and MTX may have a beneficial role in the immediate management of acute SCI.

The effect of thiocolchicoside on cerebral vasospasm following experimental subarachnoid hemorrhage in the rabbit.

BACKGROUND: This study investigated the effects of thiocolchicoside to prevent cerebral vasospasm in a rabbit model of subarachnoid hemorrhage. METHODS: Twenty-four adult male New Zealand white rabbits were randomly divided into three groups of eight rabbits each: group 1 (control), group 2 (subarachnoid hemorrhage), group 3 (treatment). Thiocolchicoside (4 mg/kg, intraperitoneally) was administered just before intracisternal blood injection and continued for 72 h once a day in the same dose for group 3. Animals were killed 72 h after subarachnoid hemorrhage. Basilar artery cross-sectional areas and arterial wall thicknesses were measured in all groups. RESULTS: Intraperitoneal administration of thiocolchicoside was found to attenuate cerebral vasospasm after subarachnoid hemorrhage in rabbits. Thiocolchicoside treatment was determined to be effective in increasing the luminal area and reducing the wall thickness of the basilar artery. CONCLUSIONS: Our findings, for the first time, showed that TCC can prevent vasospasm induced by SAH. Our results also showed that GABAergic activity may play an important role in cerebral vasospasm etiopathogenesis. In conclusion, the thiocolchicoside treatment might be beneficial in preventing vasospasm after subarachnoid hemorrhage, thus showing potential for clinical application.

Effects of darbepoetin-α in spinal cord ischemia-reperfusion injury in the rabbit.

BACKGROUND: Darbepoetin-alpha (DA) is a novel erythropoiesis-stimulating agent developed for treating anemia. In animal models, recombinant human erythropoietin has been reported to be beneficial for neuroprotection. In this study, we determined whether DA would protect the spinal cord against ischemia-reperfusion injury in a rabbit model. METHODS: Forty rabbits were randomized into five groups of eight animals each: group 1 (sham), group 2 (ischemia), group 3 (vehicle), group 4 (30 mg/kg methylprednisolone), group 5 (30 µg/kg DA). Only laparotomy was performed in the sham group. In all the other groups, the spinal cord ischemia model was created by a 20-min occlusion of the aorta just caudal to renal artery with an aneurysm clip. The drugs were administered immediately after the clamp was removed. The animals were killed 24 h later. Spinal cord segments between L2 and L5 were harvested for analysis. Neurological evaluation was performed with the Tarlov scoring system just before the animals were killed. Level of tissue malondialdehyde was analyzed as a marker of lipid peroxidation and tissue caspase-3 activity as a marker of apoptosis. Also, histopathological evaluation of the tissues was performed. RESULTS: Both malondialdehyde and caspase-3 levels were significantly decreased by DA administration. Histopathological evaluation of the tissues also demonstrated decrease in neuronal degeneration and infiltration parameters after DA administration. In the DA group, neurological outcome scores were statistically significantly better compared with the ischemia and the vehicle groups. CONCLUSIONS: Although further studies considering different dose regimens and time intervals are required, DA was shown to be at least as effective as methylprednisolone in spinal cord ischemia/reperfusion model.

Chronic subdural hematoma associated with an arachnoid cyst in a juvenile taekwondo athlete: a case report and review of the literature.

Both chronic subdural hematoma and arachnoid cysts are common lesions in neurosurgical practice. Arachnoid cysts are a well-known predisposing factor for chronic subdural hematoma. Here, we present a 12-year-old taekwondo athlete with chronic subdural hematoma associated with arachnoid cysts. The chronic subdural hematoma was evacuated through 2 burr holes and the patient was discharged in good condition. To our knowledge, this is the first case of chronic subdural hematoma with associated arachnoid cysts in a taekwondo athlete. We also review the literature on sports-related chronic subdural hematomas associated with arachnoid cysts in children.

Spontaneous elevation of a ping-pong fracture: case report and review of the literature.

Depressed skull fractures compromise 7-10% of the children admitted to hospital with a head injury. Depressed skull fractures that occur in children younger than 1 year are different from those found in older children. In neonates and infants, a depressed fracture forms an inward buckling of the bones forming a 'cup shape', termed a 'ping-pong fracture'. In neonates, spontaneous elevation of a ping-pong fracture after birth trauma is well documented. However, in infants, spontaneous elevation of a ping-pong fracture following head injury is extremely rare. Here, we present the case of an 11-month-old child, in whom a ping-pong fracture was spontaneously elevated within 2 h. In addition, the relevant literature is reviewed and discussed.

Aneurysms of the distal anterior cerebral artery: a clinical series.

BACKGROUND AND PURPOSE: Distal anterior cerebral artery (DACA) aneurysms, also called pericallosal or A2 aneurysms, are rare and comprise about 1.5 to 9% of all intracranial aneurysms. In this study, a series of 10 patients with DACA aneurysms who were surgically treated in our clinic is presented and discussed, focusing on their clinical features and sur-gical outcomes. MATERIAL AND METHODS: A total of 344 patients with cerebral aneurysms were operated on in our clinic and 10 patients (2.9%) with DACA aneurysms were studied retrospectively. All patients underwent a computed tomography (CT) scan followed by four-vessel digital subtraction angiography (DSA). RESULTS: Initial CT revealed intracerebral haematoma (ICH) in 7 patients (70%) and in 2 of them the haematoma was over 3 cm in diameter. The pericallosal-callosomarginal bifurcation was the most common location in 9 patients (90%). Four cases (40%) showed multiple aneurysms. The mean waiting time for the operation was 4.8 days. Surgical clipping was performed in all the cases. Multiple aneurysms required two different craniotomies in the same session. The patients with ICH over 3 cm in diameter, in addition to poor preoperative grade, are likely to have a poor outcome, and so clinical grade is the definite factor affecting the surgical outcome of patients. CONCLUSIONS: DACA aneurysms are usually small and bleeding occurs irrespective of their size because of the lack of resistant arachnoid membranes at the level of the pericallosal cisterns. All DACA aneurysms, even if very small in size or discovered incidentally, should be aggressively treated because of the high tendency to rupture.

Rapid resolution of acute epidural hematoma: case report and review of the literature.

Acute epidural hematomas present a serious and urgent condition. Standard management is early diagnosis and immediate surgical evacuation. Otherwise, there is a high risk of quick deterioration and death. Only patients with small asymptomatic epidural hematomas can be managed conservatively with close observation. We present a case of traumatic right temporal epidural hematoma. This is one of the rare cases of rapid spontaneous resolution of epidural hematomas within hours. Various possible mechanisms to explain the rapid resolution are discussed together with a review of the literature regarding the conservative treatment of epidural hematoma.

Intracerebral hematoma following lumboperitoneal shunt insertion: a rare case report.

Lumboperitoneal shunting is widely used for the surgical management of pseudotumor cerebri and other pathologies such as communicating hydrocephalus. Although it is a safe method, it could be associated with complications including subarachnoid hemorrhage, subdural and rarely intracerebral hematoma. A 44-year-old female applied to our clinic with complaints of severe headache, retroorbital pain and blurred vision. Lumbar puncture demonstrated cerebrospinal fluid opening pressure of cmH2O. A non-programmable lumboperitoneal shunt with two distal slit valves was inserted due to pseudotumor cerebri. She deteriorated shortly after surgery. Immediate cranial computed tomography scan revealed a right parietal intracerebral hematoma. Development of intracerebral hematoma following lumboperitoneal shunt is a rare complication. We discuss this rare event accompanied by the literature.

Flow Diverter Stents in the Treatment of Cerebral Aneurysms Less than 5 mm.

AIM: To evaluate the safety and efficacy of flow diverter (FD) stents in the treatment of intracranial aneurysms less than 5 mm. MATERIAL AND METHODS: We treated 66 aneurysms in 43 patients with aneurysms less than 5 mm. Of the patients, 29 were females and 14 males (mean age: 50.2 years). Headache was the most frequent symptom. In 8 patients, the aneurysms were recanalized and these had been treated with coils or stent-assisted coiling. All aneurysms were in the anterior circulation. In the treatment, one of the SILK, Pipeline, Derivo or FRED FD stents was used for each patient. Neurointerventional stent medication (double antiplatelet) was used. All patients were investigated for new ischemic lesions with diffusion-weighted imaging one day later. The first follow-up angiogram was planned 3-6 months later. RESULTS: The treatment was technically successful in all patients. Minor complications occurred in 3 patients (7%). In one patient, thrombus inside the SILK was seen and was relieved with tirofiban. The second patient bled from the right common femoral artery entrance, which was operated on. In the third patient, the complication was technical. All patients were discharged without any neurological deficit. The mean follow-up period was 26 (6-52) months. Of the aneurysms, 64 (97.0%) were completely closed. CONCLUSION: The FD treatment of cerebral, anterior circulation small aneurysms less than 5 mm is effective and safe.

Intradural lipoma of the cervicothoracic spinal cord with intracranial extension.

INTRODUCTION: Intradural spinal lipoma is rare and seen about 1% of all tumors of the spinal cord. Lipomas of the cervical location with intracranial extension are extremely rare and are described as intramedullary or subpial location. CASE: A 12-year-old female with lipoma of the cervicothoracic spinal cord demonstrated progressive quadriparesis. The patient underwent surgery with decompression of the affected craniocervical location. DISCUSSION: In the reported case, we describe a rare intradural lipoma of the cervicothoracic spinal cord with posterior fossa extension in the child, and the relevant English medical literature is reviewed.