Neurologia medico-chirurgica
Online ISSN : 1349-8029
Print ISSN : 0470-8105
ISSN-L : 0470-8105
Astrocytoma in the Medulla Oblongata diagnosed by Magnetic Resonance Imaging
Surgical Case Report
Toshihiro SUGAShin-ichiro TAKAHASHIMakoto SONOBEKeiji KOSHUShigeru HIROTAHiroshi KAWAKAMIKyoichi FUJIITsuneo NAMIKI
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1987 Volume 27 Issue 12 Pages 1185-1189

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Abstract
A 22-year-old male was admitted to Mito National Hospital with complaints of persistent, progressive dysphagia, hoarseness, and numbness over his entire body. Neurological examination showed bilateral 7th, 9th, and 10th nerve paralysis, tetraparesis, sensory disturbance of the whole body, and hyper-reflexia of all extremities. Pale, low-density areas in the medulla oblongata and upper cervical spinal cord were detected by conventional computed tomography. Magnetic resonance imaging (MRI) disclosed low-signal masses involving those areas and in the lower cervical cord. Suboccipital craniotomy exposed a solid, firm, well demarcated intramedullary tumor in the medulla oblongata. The tumor was removed en bloc and was histologically diagnosed as a pilocytic astrocytoma. The postoperative course was uneventful and the patient's symptoms improved dramatically. Postoperative MRI revealed no residual tumor in the medulla oblongata or upper cervical cord. This case illustrates the value of preoperative MRI, which precisely delineates the location and extent of the tumor and greatly facilitates direct surgery of the medulla oblongata.
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© The Japan Neurosurgical Society
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