Open AccessDiffuse midline glioma in the spinal cord with rapid respiratory deterioration
Author(s) -
Kamidani Ryo,
Okada Hideshi,
Yasuda Ryu,
Yoshida Takahiro,
Kusuzawa Keigo,
Ichihashi Masahiro,
Kakino Yoshinori,
Oiwa Hideaki,
Kitagawa Yuichiro,
Fukuta Tetsuya,
Suzuki Kodai,
Okamoto Haruka,
Miyake Takahito,
Tachi Masahito,
Kanda Norihide,
Iwai Chizuo,
Shiba Masato,
Yamada Noriaki,
Nozawa Satoshi,
Nakayama Noriyuki,
Doi Tomoaki,
Fushimi Kazunari,
Yano Hirohito,
Tomita Hiroyuki,
Yoshida Shozo,
Iwama Toru,
Ogura Shinji
Publication year - 2020
Publication title -
acute medicine and surgery
Language(s) - English
Resource type - Journals
ISSN - 2052-8817
DOI - 10.1002/ams2.500
Subject(s) - medicine , respiratory failure , hypoxemia , glioma , weakness , spinal cord , spinal cord compression , mechanical ventilation , status epilepticus , sepsis , anesthesia , bradycardia , myelopathy , intensive care unit , respiratory system , surgery , radiology , intensive care medicine , epilepsy , heart rate , cancer research , psychiatry , blood pressure
Background Neurogenic acute respiratory failure is usually caused by either infection or vascular insufficiency. We report the case of a patient who developed acute respiratory failure secondary to a spinal tumor. Case Presentation A 32‐year‐old man, presenting with numbness and muscle weakness in his legs for 2 weeks, was transferred to our hospital with worsening quadriplegia and development of respiratory symptoms. We carried out emergent spinal decompression and initiated steroid pulse therapy, with no resolution of symptoms; a tumor incision biopsy after contrast cervical magnetic resonance imaging revealed an intraspinal tumor with a pathological diagnosis of World Health Organization grade IV glioma. The patient developed bradycardia, severe sepsis, status epilepticus, and cardiopulmonary arrest due to hypoxemia and was treated with chemoradiotherapy under mechanical ventilation. He was later transferred to another hospital for subacute care. Conclusion Acute respiratory failure caused by spinal tumors is uncommon. However, acute care practitioners should be mindful of neoplastic lesions as a potential cause.