Fig. 32.

Dorsal lipoma with bulky pyramid placode – lesson learned. A : Note tall pyramid-shaped neural placode on axial MRI, with steep sides slopes interfacing with the lipoma. B : Lipoma stalk and dorsal lipoma. C : After lipoma resection, the placode is bulky in the middle and has thin pial fringes. D : Only the loose caudal part of the placode was neurulated. Rostral bulky part is left open because of TcMEP deterioration on forced attempts to suture. Reprinted from Pang [55] with permission from the Japanese Neurosurgical Society. MRI : magnetic resonance imaging, TcMEP : transcortical motor evoked potentials.