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Journal of Case Reports
Intramural Hemorrhage of Cervical Ependymoma in Von Willebrand’s Coagulopathy
Asma Mohammaddin1,2, Muhamad Almahayni3, Ahmed Alkhani1,2,4 
1School of Medicine, Alfaisal University; 2Department of Neurosurgery, 3Department of Adult Hematology and Bone Marrow Transplant, Oncology, King Faisal Specialist Hospital and Research Center; 4Department of Neurosurgery, King Abdulaziz Medical city, National Guard Health Affairs, Riyadh, Saudi Arabia.
Corresponding Author:
Dr. Ahmed Alkhani
Email: alkhani@yahoo.com
Received: 16-DEC-2017 Accepted: 05-JUNE-2018 Published Online: 30-JUL-2018
DOI: http://dx.doi.org/10.17659/01.2018.0049
Background: Spinal cord tumors are rare. Majority originate in glial cells. Ependymoma are the most common intra-medullary tumors in adults. Intra-mural hemorrhage is a rare presentation. Coagulopathy may contribute to such a presentation. Case Report: A 38-year-old male, known to have mild bleeding disorder presented with a sudden-onset neck pain. Magnetic resonance images (MRI) of the spine demonstrated an intra-medullary mass extending from C5-T1 with a cystic component that has features of sub-acute hemorrhage like fluid-fluid level sign. The patient underwent C5-T1 laminectomy, midline myelotomy, and microscopic total resection of the spinal classical ependymoma with intra-mural hemorrhage. Hematological investigation suggested the diagnosis of low von Willebrand factor (VWF). Conclusion: This is a rare case of an intra-medullary ependymoma that presented with intra-mural hemorrhage.
Keywords : Brain Stem Neoplasms, Ependymoma, Magnetic Resonance Imaging, Neck Pain, von Willebrand Factor.
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