A hallmark of ISCM is rapid neurological progression with up to 30-45% of symptomatic patients presenting with Brown-Sequard or pseudo Brown-Sequard Syndrome [28, 52, 59]. Up to 50% of patients with ISCM are asymptomatic until death [51]. However, once symptoms develop, disease course can be devastating with up to 75% of patients experiencing progression to full neurological deficit within one-month and mean survival time of one to four months [28, 52, 53, 60, 61, 63, 71]. Treatment consists primarily of radiation therapy with microdissection more recently coming into the field as a valid alternative [52, 54, 55, 56, 60, 64, 71]. Timely treatment can stabilize or reverse neurological dysfunction, increase quality of life, and prolong survival [52, 54,
A hallmark of ISCM is rapid neurological progression with up to 30-45% of symptomatic patients presenting with Brown-Sequard or pseudo Brown-Sequard Syndrome [28, 52, 59]. Up to 50% of patients with ISCM are asymptomatic until death [51]. However, once symptoms develop, disease course can be devastating with up to 75% of patients experiencing progression to full neurological deficit within one-month and mean survival time of one to four months [28, 52, 53, 60, 61, 63, 71]. Treatment consists primarily of radiation therapy with microdissection more recently coming into the field as a valid alternative [52, 54, 55, 56, 60, 64, 71]. Timely treatment can stabilize or reverse neurological dysfunction, increase quality of life, and prolong survival [52, 54,