A Case of Giant Ependymomas of the Cauda Equina associated with Thoracic Intradural Spinal A-V Malformations

Spinal ependymomas originate in the ependymal lining and grow rather slowly which allows them to reach considerable size and length. The great majority of primary tumors of the cauda equina are ependymomas and show a rather marked predilection for the male. Histologically ependymomas are benign but merastasis and anaplasia have been reported. The basic architectural structures of the ependymoma are the ependymal rosettes and pseudo-rosettes. Intradural spinal arteriovenous malformmations are relatively rare lesions and found only at autopsy or incidentally during surgical operations before the advent of investigative procedure. Development of myelography and spinal angiography have shown that vascular malformations of the spinal cord are not rare. Male is more predominant than female. The etiology and pathophysiological mechanisms are uncertain but many authors have believed that congenital, trauma, inflammations, tumoral processes, vasculitis and abnormal posture are influenced on A-V malformations of the spinal cord. No reports have been noticed about giant ependymomas of the cauda equina combined with spinal A-V malformations. We have experienced a case of giant ependymomas of the cauda equina associated with thoracic intradural spinal A-V malformations in forty-two year-old male and reviewed the literatures.

Bitemporal Hemianopsia Caused by Head Injury

Visual field defects being associated with severe closed head injury is well known. The nature and frequency of these association have been reported in a few literatures. Some hypotheses have been advanced to explain the field defects, but no prospective pathological study of the visual pathways in a large number of cases with closed head injury has been made. These hypotheses as to why vision is impaired after head injury have not explained most cases, if not at all. Authors have experienced a case of traumatic, complete bitemporal hemianopsia associated with macular sparing on the right and macular splitting on the left eye in 29 year old man. The patient had a head injury with traffic accident, which caused fractures of the frontal bone and orbital roofs. The various pathogenic possibilities of the chiasmal damage and consequent visual field defects are discussed.