Lipoma of the Cauda Equina

Abstract

Although intradural lipomas of the cauda equina with extradural extension have been recognized for over a century, their importance is not widely known. The subcutaneous swelling is easily mistaken for a meningocele and sincqthere is normal skin cover and no neurological involvement in the early stageDs a conservative approach is usually advised. It is not generally appreciated that tlhe subcutaneous lipoma is in fact a mushroom-like structure with a stalk which passes intradurally and is firmly adherent to the cauda equina, the filum terminale, and the conus medullaris) 1n due course most of these lipomas cause neuro- logical symptoms. The onset of neurological involvement may be early or late. It may be sudden and severe and for this reason we now recommend early exploration, even in the absence of any neurological abnormality.