Paraparesis caused by intradural thoracic spinal granuloma secondary to organizing hematoma: illustrative case

J Neurosurg Case Lessons, 2022 · DOI: 10.3171/CASE22432 · Published: November 21, 2022

Surgery Spinal Disorders Research Methodology & Design

Simple Explanation

Spinal granulomas are inflammatory masses that can be caused by infections or non-infectious processes. This paper reports a rare case of a granuloma forming within the spinal cord due to a hematoma. The patient, a 70-year-old man, presented with lower extremity weakness. Imaging revealed a mass compressing his spinal cord, which was subsequently surgically removed. Pathology revealed the mass to be a granuloma that formed from an organizing hematoma. The patient's leg weakness improved following surgery.

Study Duration

Not specified

Participants

A 70-year-old man

Evidence Level

Level 4: Case Report

Key Findings

1
The authors present the first report of paraparesis caused by intradural granuloma secondary to organizing hematoma.
2
Severe hemodynamic changes may be associated with spinal hematomas that present insidiously and/or evolve over time.
3
Tissue diagnosis is critical because intradural granulomas can mimic vascular lesions and malignancy.

Research Summary

Spinal granulomas are rare inflammatory masses that can form within the spinal cord due to infectious or non-infectious processes. This case report details a unique instance of an intradural granuloma forming secondary to an organizing hematoma in a 70-year-old man. The patient presented with lower extremity weakness, and imaging revealed a spinal cord compression. Surgical resection of the mass resulted in improved strength and sensation in the patient's legs. The authors highlight the importance of tissue diagnosis, as these granulomas can mimic other conditions such as vascular lesions and malignancies. They also suggest a potential link between severe hemodynamic changes and the development of spinal hematomas.

Practical Implications

Diagnostic Vigilance

Clinicians should consider granuloma as a differential diagnosis for spinal cord compression, even in the absence of typical risk factors.

Expeditious Treatment of Hypertension

Severe hemodynamic changes associated with spinal hematomas highlight the need for prompt management of refractory hypertension.

Importance of Tissue Diagnosis

Given that intradural granulomas can mimic vascular lesions and malignancies, obtaining a tissue sample for pathological analysis is crucial for accurate diagnosis and treatment planning.

Paraparesis caused by intradural thoracic spinal granuloma secondary to organizing hematoma: illustrative case

Simple Explanation

Key Findings

Research Summary

Practical Implications

Diagnostic Vigilance

Expeditious Treatment of Hypertension

Importance of Tissue Diagnosis

Study Limitations

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Was this summary helpful?

Paraparesis caused by intradural thoracic spinal granuloma secondary to organizing hematoma: illustrative case

Simple Explanation

Key Findings

Research Summary

Practical Implications

Diagnostic Vigilance

Expeditious Treatment of Hypertension

Importance of Tissue Diagnosis

Study Limitations

Your Feedback

Was this summary helpful?