M Helmi, E Dolan, F Farooq, M Ur-Raad, Z Jafar, M Weil, M Jansen, A Hegarty, O O'Toole
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Abstract
Presentation: A male patient in his 20s presented with a two-year history of progressive paraparesis and new-onset urinary incontinence. Neurological examination revealed bilateral ankle clonus, reduced lower-limb power, spastic gait and a positive Hoffmann's sign.
Diagnosis: MRI of the cervical spine demonstrated an intradural extramedullary lesion extending from C4 to C5-C6 disc level, causing severe cord compression. Histopathology confirmed schwannoma.
Treatment: The patient underwent surgical resection via anterior cervical corpectomy of C4 and C5. Postoperatively, his lower-limb strength improved, and bladder control had returned by 6 weeks.
Discussion: This case highlights an unusual lower-limb-predominant presentation of cervical schwannoma, emphasising the role of neurological examination in accurate lesion localisation.
期刊介绍：
Since its inception in 1867, the Journal of the Medical Association of Ireland and now in its present format, the Irish Medical Journal, has provided the medical community in Ireland with an invaluable service. As one of the leading biomedical publications in Ireland, it has sought to continue the education of medical students and postgraduates through scientific research, review articles and updates on contemporary clinical practices while providing an ongoing forum for medical debate. A measure of our stature is that we are listed in the Index Medicus and issued annually with a citation factor from the Institute for Scientific Information.
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