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Case Reports
. 2013 Jul;16(3):440-2.
doi: 10.4103/0972-2327.116935.

Spinal coning after lumbar puncture in a patient with undiagnosed giant cervical neurofibroma

Prasad Krishnan  1 , Siddhartha Roychowdhury
Affiliations
Case Reports

Spinal coning after lumbar puncture in a patient with undiagnosed giant cervical neurofibroma

Prasad Krishnan et al. Ann Indian Acad Neurol. 2013 Jul.

Abstract

Lumbar puncture in the presence of an intracranial tumor with raised intracranial pressure is known to have catastrophic consequences due to herniation of intracranial contents through the tentorial hiatus or foramen magnum. There are relatively few case reports about the same sequence of events when lumbar puncture is performed below the level of a complete spinal block. The mechanism of such deterioration is also subject to conjecture as the spinal cord (unlike the uncus or cerebellar tonsils) is tethered by the dentate ligament and roots on either side, and is hence less mobile. We present one such case of spinal coning and review the available literature.

Keywords: Cervical neurofibroma; lumbar puncture; spinal coning.

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Conflict of interest statement

Conflict of Interest: Nil

Figures

Figure 1
Figure 1
T2 sagittal image showing a partially solid and cystic mass extending from C3–C4 disc space to D3 body level
Figure 2
Figure 2
Coronal images showing a right-sided cervicodorsal lesion enhancing on contrast except at center and pushing cord to the left
Figure 3
Figure 3
Axial images showing well-marginated lesion lying to the right side of the cord
Figure 4
Figure 4
Postoperative tumor specimen with solid and cystic areas
See this image and copyright information in PMC

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