Spinal angiomas. The meaning of cerebrospinal fluid lactic acid in the etiology and differential diagnosis of transverse myelopathy.

We report five out of eleven patients with transverse myelopathy due to spinal angiomas. Transverse myelopathy can be caused by a number of disorders. The formation of lactic acid points to ischaemia within the spinal cord, due to altered haemodynamics as in spinal angiomas. The meaning of cerebrospinal fluid lactic acid is discussed with respect to etiology and differential diagnosis of transverse myelopathy. The combined finding of CSF lactic acid and protein elevation in the absence of cell count and immunological and/or serological abnormalities points to an isolated vascular cause of the transverse myelopathy.