Acute presentation of spinal epidural cavernous angiomas: Case report

Giuseppe Caruso, Marcelo Galarza, Ignazio Borghesi, Eugenio Pozzati, Mario Vitale

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: Spinal extramedullary hematomas stemming from cavernous angiomas in the epidural compartment are rare. It is more common for spinal epidural cavernous angiomas to present with slow and progressive myelopathy or radiculopathy. They seldom present with clinical evidence of acute spinal cord or nerve root compression. CLINICAL PRESENTATION: Three consecutive cases of acute spinal cavernous angiomas with overt neurological deficits were presented. These presentations included acute onset of neck pain and tetraparesis, bilateral lower extremity pain and paraparesis, and acute sciatic pain with plantar flexor weakness. The lesions were located in the cervical, thoracic, and sacral spine, respectively. The cases included either abrupt lesion enlargement secondary to a pure intralesional hemorrhage or a cavernous hemorrhage that invaded the epidural space. INTERVENTION: All patients were treated with either laminotomy or complete resection of the hematoma and cavernoma within 12 hours after admission. CONCLUSION: Spontaneous spinal epidural hematomas presented with significant pain and acute spinal cord and nerve root compression may represent the manifestation of a cavernous angioma. Appropriate interpretation of preoperative imaging studies may prevent delay in proper management, especially for patients in whom nerve root deficit is the only clinical expression.

Original languageEnglish
JournalNeurosurgery
Volume60
Issue number3
DOIs
Publication statusPublished - Mar 2007

Keywords

  • Cavernous angiomas
  • Nerve root compression
  • Spinal cord compression
  • Spontaneous epidural hematoma

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

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