Ventral Cervical Spinal Schwannoma Presenting as Progressive Myelopathy

Abstract

Presentation
A male patient in his 20s presented with a two-year history of progressive paraparesis and new-onset urinary incontinence. Neurological examination revealed bilateral ankle clonus, reduced lower-limb power, spastic gait and a positive Hoffmann’s sign.

Diagnosis
MRI of the cervical spine demonstrated an intradural extramedullary lesion extending from C4 to C5–C6 disc level, causing severe cord compression. Histopathology confirmed schwannoma.

Treatment
The patient underwent surgical resection via anterior cervical corpectomy of C4 and C5. Postoperatively, his lower-limb strength improved, and bladder control had returned by 6 weeks.

Discussion
This case highlights an unusual lower-limb–predominant presentation of cervical schwannoma, emphasising the role of neurological examination in accurate lesion localisation.