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1241 - Intramedullary Tumor leading to Central Cord Syndrome: A Case Report

Thursday, February 27, 2025

5:00 PM - 6:30 PM MST

Presenting Author(s)

KP

Kevin Paul, DO

Physician
Mercy Hospital
Rockville Centre, New York, United States

Co-Author(s)

AD

Amritjot Dhillon, BS

Medical Student
Touro College of Osteopathic Medicine
Middletown, New York, United States
VS

Vasanth Selvam, DO

Physician Resident
Mercy Hospital
Floral Park, New York, United States
PS

Perry Stein, MD

Physician
Mercy Hospital
Rocville Centre, New York, United States

Case Diagnosis: Central Cord Syndrome Secondary to Intramedullary Tumor

Case Description: A 58-year-old male with a history of cervical disc disease and recent cervical fusion surgery (7 months prior) presented with progressive weakness in both the upper and lower extremities. Initial imaging at an outside facility revealed complex cervical cord fluid, suggesting possible hemorrhage or hematomyelia, and prompted a recommendation for emergent spine surgery. During a cervical laminectomy (C2-C7), an intramedullary tumor was unexpectedly identified and successfully resected. Postoperatively, the patient demonstrated significant functional improvement through physical and occupational therapy, regaining strength and mobility in both the upper and lower extremities.

Discussions: Central cord syndrome (CCS) is a neurological condition resulting from a lesion in the central portion of the cervical spine, often caused by traumatic injury. It is characterized by greater weakness in the upper limbs compared to the lower limbs and is most commonly seen in older adults following hyperextension injuries. However, CCS can also arise from rare causes such as intramedullary tumors, vascular anomalies, or cavitations within the spinal cord. This case report presents a unique instance of CCS due to an intramedullary spinal cord tumor, highlighting the importance of recognizing non-traumatic causes of the condition.

Conclusions: In this case, a rare presentation of central cord syndrome (CCS) was caused by an intramedullary tumor rather than the more common etiologies, such as trauma. This underscores the importance of considering atypical causes in patients with progressive weakness. The patient's history of cervical disc disease, recent fusion surgery, and initial imaging, which did not reveal a tumor, may have contributed to diagnostic complexity, with initial concerns for hemorrhage or hematomyelia. Surgical intervention, including cervical laminectomy and tumor resection, led to notable recovery through physical and occupational therapy, underscoring the value of prompt diagnosis and multidisciplinary management in optimizing functional outcomes.