Download PDF
CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(03): 1033-1036
DOI: 10.4103/ajns.AJNS_249_18
Case Report

Cavernous malformation of a thoracic spinal nerve root: Case report and review of literature

Juan Vicenty
Department of Surgery, Neurosurgery Section, University of Puerto Rico, Medical Science Campus, San Juan, Puerto Rico
,
Ricardo Fernandez-de Thomas
Department of Surgery, Neurosurgery Section, University of Puerto Rico, Medical Science Campus, San Juan, Puerto Rico
,
Samuel Estronza
Department of Surgery, Neurosurgery Section, University of Puerto Rico, Medical Science Campus, San Juan, Puerto Rico
,
Miguel Mayol-Del Valle
Department of Surgery, Neurosurgery Section, University of Puerto Rico, Medical Science Campus, San Juan, Puerto Rico
,
Emil Pastrana
Department of Surgery, Neurosurgery Section, University of Puerto Rico, Medical Science Campus, San Juan, Puerto Rico
› Author Affiliations
› Further Information
Also available at
  Permissions and Reprints

Intradural extramedullary spinal cavernous malformations (CMs) remain the least common variant of these lesions and can originate from the inner surface of the dura mater, the pial surface of the spinal cord, and the blood vessels in the spinal nerves. Root-based-only extramedullary CMs are very rare in the thoracic region with only four cases reported. We present a case of 56-year-old male with 1-year progression of lower extremities weakness. Magnetic resonance imaging demonstrated a hyperintense lesion in the upper thoracic region. Surgical exploration revealed a CM with origin in the second thoracic nerve root with gross total resection. Histopathological examination confirmed a CM. The patient had complete recovery of neurological function at 3 months interval. Intradural extramedullary CM is extremely rare entity that must be considered in the differential diagnosis of intradural extramedullary lesions. Surgical resection is the treatment of choice to prevent further neurological damage.

Key-words:

Cavernous malformation - extramedullary - intradural - vascular

Financial support and sponsorship

Nil.




Publication History

Article published online:
09 September 2022

© 2019. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Lanotte M, Massaro F, Faccani G, Forni M, Valentini MC. Dumbbell-shaped spinal epidural cavernous angioma. Case report. Ital J Neurol Sci 1994;15:429-32.
  • 2 Er U, Yigitkanli K, Simsek S, Adabag A, Bavbek M. Spinal intradural extramedullary cavernous angioma: Case report and review of the literature. Spinal Cord 2007;45:632-6.
  • 3 Fahlbusch R, Strauss C, Huk W, Röckelein G, Kömpf D, Ruprecht KW, et al. Surgical removal of pontomesencephalic cavernous hemangiomas. Neurosurgery 1990;26:449-56.
  • 4 Padovani R, Acciarri N, Giulioni M, Pantieri R, Foschini MP. Cavernous angiomas of the spinal district: Surgical treatment of 11 patients. Eur Spine J 1997;6:298-303.
  • 5 Mastronardi L, Ferrante L, Scarpinati M, Gagliardi FM, Celli P, Fortuna A, et al. Intradural extramedullary cavernous angioma: Case report. Neurosurgery 1991;29:924-6.
  • 6 Abul-Kasim K, Thurnher MM, McKeever P, Sundgren PC. Intradural spinal tumors: Current classification and MRI features. Neuroradiology 2008;50:301-14.
  • 7 Caroli E, Acqui M, Trasimeni G, Di Stefano D, Ferrante L. A case of intraroot cauda equina cavernous angioma: Clinical considerations. Spinal Cord 2007;45:318-21.
  • 8 Roger H, Paillas JE, Bonnal J, Vigorous M. Angiomes de la moelle et des racines. Acta Neurol Psych Belgium 1951;7:491-5.
  • 9 Floris V. Angiomie angiomatosi del sistema nervoso. Lav Neuropsich 1958;27:159-79.
  • 10 Heimberger K, Schnaberth G, Koos W, Pendl G, Auff E. Spinal cavernous haemangioma (intradural-extramedullary) underlying repeated subarachnoid haemorrhage. J Neurol 1982;226:289-93.
  • 11 Pagni CA, Canavero S, Forni M. Report of a cavernoma of the cauda equina and review of the literature. Surg Neurol 1990;33:124-31.
  • 12 Mastronardi L, Ferrantel L, Scarpinati M, Gigliardi FM, Celli P, Fortuna A. Intradural extramedullary cavernous angioma: Case report. Neurosurgery 1991;29:924-6.
  • 13 Mori K, Ishii H, Tomita Y, Nakajima K, Morimoto K, Maeda M. Intradural-extramedullary spinal cavernous angioma – Case report. Neurol Med Chir (Tokyo) 1991;31:593-6.
  • 14 Sharma R, Rout D, Radhakrishnan VV. Intradural spinal cavernomas. Br J Neurosurg 1992;6:351-6.
  • 15 Rao GP, Bhaskar G, Hemaratnan A, Srinivas TV. Spinal intradural extramedullary cavernous angiomas: Report of four cases and review of the literature. Br J Neurosurg 1997;11:228-32.
  • 16 Rachinger J, Buslei R, Engelhorn T, Doerfler A, Strauss C. Intradural-extramedullary cavernous hemangioma of the left motor root C7 – Case report and update of the literature. Zentralbl Neurochir 2006;67:144-8.
  • 17 Cansever T, Civelek E, Sencer A, Karasu A, Kiriş T, Hepgül K, et al. Spinal cavernous malformations: A report of 5 cases. Surg Neurol 2008;69:602-7.
  • 18 Bruni P, Massari A, Greco R, Hernandez R, Oddi G, Chiappetta F, et al. Subarachnoid hemorrhage from cavernous angioma of the cauda equina: Case report. Surg Neurol 1994;41:226-9.
  • 19 Mataliotakis G, Perera S, Nagaraju S, Marchionni M, Tzerakis N. Intradural extramedullary cavernoma of a lumbar nerve root mimicking neurofibroma. A report of a rare case and the differential diagnosis. Spine J 2014;14:e1-7.
  • 20 Nie QB, Chen Z, Jian FZ, Wu H, Ling F. Cavernous angioma of the cauda equina: A case report and systematic review of the literature. J Int Med Res 2012;40:2001-8.
  • 21 Duke BJ, Levy AS, Lillehei KO. Cavernous angiomas of the cauda equina: Case report and review of the literature. Surg Neurol 1998;50:442-5.
  • 22 Acciarri N, Padovani R, Pozzati E, Gaist G, Manetto V. Spinal cavernous angioma: A rare cause of subarachnoid hemorrhage. Surg Neurol 1992;37:453-6.
  • 23 Spetzler RF, Detwiler PW, Riina HA, Porter RW. Modified classification of spinal cord vascular lesions. J Neurosurg 2002;96:145-56.