Complete surgical resection is a well-known therapeutic gold standard for spinal ependymoma, but it is associated with high postoperative morbidity. Intraoperative neuromonitoring (INM) is important for detecting and reducing the rate of surgical complications during this operative procedure. We report a case of postoperative paraplegia due to tumor bleeding during the operation. INM of the patient revealed abrupt loss of waveforms during the operation. This finding suggested that INM is helpful for detecting intraoperative hematomyelia and minimizing postoperative neurologic sequelae.

Germ-cell tumors (GCTs) are common in the central nervous system. GCTs are highly sensitive to radiotherapy and chemotherapy and can be cured without radical surgery. However, this tumor produces nonspecific imaging findings, and its rarity can make diagnosis challenging. Here we report a case in which the first diagnosis was uncertain and follow-up imaging revealed intramedullary germinoma. The patient underwent chemotherapy and radiotherapy after the diagnosis.