J L Stone1, T Lichtor, J R Ruge. 1. Department of Neurological Surgery, Cook County Hospital, Chicago, Illinois, USA.
Abstract
STUDY DESIGN: The treatment of a patient with progressive neurologic deficit secondary to a cavernous angioma located in the dorsal midline of the upper-most cervical spinal cord was described. OBJECTIVES: An illustrative case of a patient with an exophytic cavernous angioma of the cervical spinal cord near the cervicomedullary junction was presented, the literature reviewed, and the treatment of these patients discussed. SUMMARY OF BACKGROUND DATA: Cavernous angiomas of the spinal cord were rarely seen, and only more recently appreciated with the advent of MRI scanning. These lesions were usually intramedullary in location. Intradural extramedullary cavernous angiomas, or intramedullary lesions with exophytic extramedullary extension, were particularly rare and usually occurred at the cauda equina. METHODS: The surgical treatment of a patient with an exophytic cavernous angioma of the upper cervical spinal cord was presented. RESULTS: This patient underwent surgery after a hemorrhage that occurred after the patient was treated conservatively for several years. The entire lesion was resected with standard microsurgical technique, and the neurologic symptoms subsequently resolved. CONCLUSIONS: This entity should be suspected in the differential diagnosis of patients with progressive and step-wise deterioration of spinal cord function. Although these patients can be treated conservatively, those with progressive neurologic deficits should undergo microsurgical resection to avert subsequent lesion enlargement or repeated hemorrhage.
STUDY DESIGN: The treatment of a patient with progressive neurologic deficit secondary to a cavernous angioma located in the dorsal midline of the upper-most cervical spinal cord was described. OBJECTIVES: An illustrative case of a patient with an exophytic cavernous angioma of the cervical spinal cord near the cervicomedullary junction was presented, the literature reviewed, and the treatment of these patients discussed. SUMMARY OF BACKGROUND DATA: Cavernous angiomas of the spinal cord were rarely seen, and only more recently appreciated with the advent of MRI scanning. These lesions were usually intramedullary in location. Intradural extramedullary cavernous angiomas, or intramedullary lesions with exophytic extramedullary extension, were particularly rare and usually occurred at the cauda equina. METHODS: The surgical treatment of a patient with an exophytic cavernous angioma of the upper cervical spinal cord was presented. RESULTS: This patient underwent surgery after a hemorrhage that occurred after the patient was treated conservatively for several years. The entire lesion was resected with standard microsurgical technique, and the neurologic symptoms subsequently resolved. CONCLUSIONS: This entity should be suspected in the differential diagnosis of patients with progressive and step-wise deterioration of spinal cord function. Although these patients can be treated conservatively, those with progressive neurologic deficits should undergo microsurgical resection to avert subsequent lesion enlargement or repeated hemorrhage.
Authors: Sven O Eicker; Sve O Eicker; Andrea Szelényi; Christian Mathys; Hans-Jakob Steiger; Daniel Hänggi Journal: Neurosurg Rev Date: 2013-04-09 Impact factor: 3.042