ABSTRACT
We present a case of neurocutaneous melanosis in a 1-year-old child who presented with progressive quadriparesis created by an infiltrating extra-axial neoplastic melanin-producing tumor at the foramen magnum. This extensive intra-arachnoid mass filled the basal cisterns of the brain and surrounded the upper cervical cord. An imaging clue to the diagnosis was apparent as T1-weighted shortening on magnetic resonance in the pia and/or cortex of the cerebellar folia, suggesting the presence of melanin.
Subject(s)
Cervical Vertebrae , Melanins/metabolism , Neuroectodermal Tumor, Melanotic/diagnosis , Spinal Cord Compression/diagnosis , Spinal Neoplasms/diagnosis , Cervical Vertebrae/pathology , Cervical Vertebrae/surgery , Diagnosis, Differential , Foramen Magnum/pathology , Foramen Magnum/surgery , Humans , Infant , Laminectomy , Melanoma/diagnosis , Melanoma/pathology , Melanoma/surgery , Neuroectodermal Tumor, Melanotic/pathology , Neuroectodermal Tumor, Melanotic/surgery , Spinal Cord Compression/pathology , Spinal Cord Compression/surgery , Spinal Neoplasms/pathology , Spinal Neoplasms/surgeryABSTRACT
We report 2 cases of children who developed a delayed hemiparesis following minor closed head injury with no alteration in consciousness and normal CT studies. MRI showed focal lesions in the ventral pons contralateral to the hemiparesis. Both patients recovered to near normal neurologic function within several days of injury. We postulate a mechanism of injury based on focal contusion of perforating brainstem arteries resulting in the delayed onset of vasospasm.