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PubMed · 17077638

Postirradiation spinal root cavernoma.

Pierre Labauge·Anne Lefloch·Françoise Chapon·Giovanni Castelnovo·Antoine Maubon·Valerie Rigau·François Segnarbieux
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Hemangioma, Cavernous, Central Nervous SystemHodgkin DiseaseHumansMagnetic Resonance ImagingMaleMiddle AgedNeoplasms, Radiation-InducedPeripheral Nervous System NeoplasmsSpinal Nerve RootsCase ReportsLetter

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Pierre Labauge, Anne Lefloch, Françoise Chapon, Giovanni Castelnovo, Antoine Maubon, Valerie Rigau, François Segnarbieux. 2006-10-23. Postirradiation spinal root cavernoma.. https://doi.org/10.1159/000096676

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PubMed2006

Intradural-extramedullary cavernous hemangioma of the left motor root C7--case report and update of the literature.

OBJECTIVE: Intradural-extramedullary cavernomas of the spine are rare lesions with only 21 published cases to date. Due to their rareness and special characteristics diagnosis often is difficult. We report on an additional case of an intradural-extramedullary cavernoma of the spine. PATIENT: A 56-year-old male presented with left shoulder pain and acute onset of pain affecting the whole spinal column two weeks prior to admission. There were no motor deficits, but a hypesthesia corresponding to the right distal C8-dermatome. MRI revealed an intradural-extramedullary, expansive lesion at the level of C6 with a hyperintense appearance in both T (1)- and T (2)-weighted images. Neither a hemosiderin rim nor contrast enhancement was visible. RESULTS: During surgery a hematoma and a reddish, berry-like tumor adherent to the left motor root C7 were removed. There were no new neurological deficits, and shoulder and back pain resolved within a few weeks after surgery. Histopathologically a cavernous hemangioma was diagnosed. CONCLUSIONS: The patient's symptoms were caused both by direct nerve compression and by spinal hemorrhage, most likely spinal SAH. As there was no characteristic hemosiderin rim and due to the hyperintense appearance in T (1)- and T (2)-weighted MR scans, a radiological diagnosis of hemorrhage and classification of the lesion was difficult. Despite their rareness, in patients with signs of spontaneous, spinal SAH and/or nerve compression syndromes cavernous hemangiomas have to be considered as a potential cause.

Hemangioma, Cavernous, Central Nervous System↗
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[Wallenberg's syndrome as the presenting symptom of a cavernous angioma].

INTRODUCTION: Cavernous angiomas account for 5-13% of all vascular malformations. In 75% of cases they are situated in the posterior fossa and up to 30% are associated with abnormal venous drainage. The main complication is haemorrhage; the presence of a neurological focus without radiological evidence of bleeding is very rare. CASE REPORT: We report the case of a 54-year-old male with cardiovascular risk factors who presented symptoms that progressively deteriorated over a 72-hour period involving the left lower cranial nerves, sensory impairment and coordination disorder, compatible with Wallenberg's syndrome. Two computerised axial tomography scans of the brain were normal and so a tentative diagnosis of ischemic stroke in progression was proposed. Five days later, magnetic resonance imaging (MR) revealed the presence of a venous angioma and associated abnormal venous drainage. CONCLUSIONS: Cavernous angiomas present a dynamic balance between intracavernous bleeding and thrombosis, with very slow venous blood flow. Upsetting this balance leads to an increase in the intracavernous pressure and involvement of the surrounding tissue, with no radiological expression of bleeding. In these cases MR scanning helps to distinguish between a vascular malformation with reduced blood flow and a clinical picture of ischemic stroke of an arterial origin.

Hemangioma, Cavernous, Central Nervous System↗