Spinal canal decompression for hypertrophic neuropathy of the cauda equina with chronic inflammatory demyelinating polyradiculoneuropathy: A case report

Figure 1 Image of T2-weighted magnetic resonance imaging. A: Diffuse thickening of nerve roots in the spinal canal is seen on magnetic resonance imaging (MRI) sagittal T2 slices (white arrow); B: Extraforaminal nerve root also showed signs of thickening on MRI sagittal T2 slices (white arrow); C: The spinal canal was almost filled with hypertrophic cauda equina on MRI axial T2 slices (white arrow).

Figure 2 Pathological findings. A: Toluidine blue staining of a cross-section of the nerve root demonstrated numerous onion bulbs and significant loss of large myelinated axons (Magnification: 200 ×); B: Immunohistochemical staining for S100 protein showing positivity of the onion bulbs (Magnification: 200 ×); C: Immunohistochemical staining for epithelial membrane antigen showing negativity of the onion bulbs (Magnification: 200 ×); D: Immunohistochemical staining for leukocyte common antigen showing negativity of the onion bulbs (Magnification: 200 ×).

Figure 3 Gross intraoperative view. A: Diffuse enlargement of exposed nerve roots (white arrow); B: The nerve root of the cauda equina selected for biopsy (white arrow).