We present a large cervicomedullary intramedullary lipoma in a 17-year-old boy, who presented with spastic quadriparesis and exaggerated reflexes. MRI revealed an intramedullary lipoma extending from the craniovertebral junction to the sixth cervical vertebra. There was no spinal dysraphism. Subtotal excision with primary dural closure was performed, which produced an improvement in the patient's condition. The technique we used is discussed.
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