Early diagnosis of cervical spinal cord meningioma

TUMORS of the foramen magnum and the upper part of the cervical spinal cord are often initially seen with confusing clinical syndromes that are frequently ascribed to a conversion hysteria or fibromyositis. In a major review of such tumors, Dodge et al1stated, "Unless the physician obtains an accurate history and attributes sufficient significance to the patient's often bizarre and at times seemingly functional complaints, he is likely to deny the patient his ultimate opportunity for cure." Despite this warning, it seems that scant attention has been given to the role of the patient's history in the early diagnosis of such tumors, and diagnostic studies are only undertaken when signs of spinal cord compression are apparent. The following case report describes a patient in whom the history of recumbent neck pain and electromyographic abnormalities suggested the diagnosis of a meningioma in the upper part of the cervical spinal cord