MOJ ISSN: 2374-6939MOJOR

Orthopedics & Rheumatology
Clinical Images
Volume 7 Issue 3 - 2017
Cervicobrachial Neuralgia Revealing a Meningioma
Zeineb Alaya1*, Lassad Hassini2, Walid Osman2, Nader Naouar2, Mohamed Laziz Ben Ayèche2 and Elyès Bouajina1
1Department of Rheumatology, Farhat Hached Hospital, Faculty of Medicine of Sousse, Tunisia
2Department of Orthopaedics, Sahloul Hospital, Faculty of Medicine of Sousse, Tunisia
Received: February 11, 2017 | Published: February 15, 2017
*Corresponding author: Dr. Zeineb Alaya, Department of Rheumatology, Farhat Hached Hospital, Faculty of medicine of Sousse, Ibn el Jazzar Street, 4000 Sousse, Tunisia, Tel: +21698375975, Email:
Citation: Alaya Z, Hassini L, Osman W, Naouar N, Ayèche MLB, et al. (2017) Fibromyalgia & Movement Therapies. MOJ Orthop Rheumatol 7(3): 00269. DOI: 10.15406/mojor.2017.07.00269

Keywords

Cervico-brachial neuralgia; Spinal MRI; Surgery, T1 sequences, C4-C5 vertebral block

Clinical Images

This is a 52-year-old patient who has been hospitalized for a straight-necked cervico-brachial neuralgia C7 of mixed type, evolving for a year, not improved by medical treatment. The examination showed a supple but painful cervical spine to movements of laterality and rotation, with abolished reflexes to the upper right limb without sensory-motor deficit. Biology did not reveal any inflammatory syndrome. The radiographs of the cervical spine showed a C4-C5 vertebral block. Spinal MRI revealed the presence of an intra-dural, extra-medullary expansive process, anterior seat located on the left opposite D1, intermediate signal on the T1 sequences (Panel A) and hypersignal on the T2 sequences (Panel B), enhanced homogeneously after gadolinium injection, measuring 2x1 cm, exerting a mass effect on the spinal cord without signal anomaly at the marrow, compatible with a meningioma (Panel C). A surgical treatment involving a D1-D2 laminectomy with complete removal of the tumor was performed. The histology of the surgical specimen concluded with a meningioma. Meningioma is one of the intra-dural and extra-medullary tumors. It can be at the origin of a tenacious NCB. The pain is intense, while cervical stiffness may be lacking. Spinal MRI shows the tumor and its repercussion on the marrow. The treatment of meningioma is surgical (Figure 1).

Figure 1: Spinal MRI: Intra-dural, extramedullary expansive process of anterior seat located on the left opposite D1, intermediate signal on the T1 sequences (A) and hypersignal on the T2 sequences (B), enhancing homogeneously after injection of gadolinium, measuring 2x1 cm, exerting a mass effect on the medullary cord without signal abnormality at the marrow (C).

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