Tumefactive multiple sclerosis requiring emergency craniotomy: case report and literature review.

Abstract

Multiple sclerosis (MS) is a demyelinating disease of the central nervous system, characterized by focal neurological dysfunction with a relapsing and remitting course. Tumor-like presentation of MS (or "tumefactive"/"pseudotumoral" presentation) has been described before with a certain frequency; it consists of a large single plaque (>2cm) with presence of edema and mass effect and it is hard to distinguish from a brain tumor. However, we present a very rare case of a 53-year-old woman with a right temporal mass that turned out to be a MS plaque, who deteriorated within hours (brain herniation with loss of consciousness and unilateral mydriasis) and required an emergency craniotomy. We also present a review of the literature. It appears that only 4 cases of emergency craniotomy/craniectomy required in a patient with a tumor-like MS plaque have been reported before.

• Authors: Pablo M Munarriz, Ana M Castaño-Leon, Rafael Martinez-Perez, Aurelio Hernandez-Lain, Ana Ramos, Alfonso Lagares
• Journal: Neurocirugia (Asturias, Spain) (Neurocirugia (Astur)) 2013 Sep-Oct Vol. 24 Issue 5 Pg. 220-4 ISSN: 1130-1473 [Print] Spain
• PMID: 23582489 (Publication Type: Case Reports, Journal Article, Review)
• Copyright: Copyright © 2012 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

Topics

• Craniotomy
• Emergency Treatment
• Female
• Humans
• Middle Aged
• Multiple Sclerosis (complications, surgery)