Spinal Epidural Cavernous Angioma: Case Report

Epidural cavernous angiomas are apparently rare lesions. We present a case of paraplegia with acute onset secondary to spinal epidural cavernous angioma at levels C7 and T1. Magnetic resonance imaging gave the clinician the opportunity to diagnose the lesion preoperatively. In this article, we present and discuss this rare case with a review of the literature.

Key words:

Cavernous Angioma - Epidural Space

References

• 1 Anson J A, Spetzler R F. Surgical resection of intramedullary spinal cord cavernous malformations.  J Neurosurg. 1993;  78 446-451
• 2 Barrow D L, Awad I A. Conceptual overview and management strategies. In: Awad IA, Barrow DL (eds). Cavernous malformations Park Ridge: American Association of Neurological Surgeons 1993: 205-213
• 3 Cosgrove G R, Bertrand G, Fontaine S, Robitaille Y, Melanson D. Cavernous angiomas of spinal cord.  J Neurosurg. 1988;  68 31-36
• 4 Curling Jr O D, Kelly Jr D L, Elster A D, Craven T E. An analysis of the natural history of cavernous angiomas.  J Neurosurg. 1991;  75 702-708
• 5 Dagi T F, Schmidek H H. Vascular tumors of the spine. In: Sundaresan N, Schimidek AL, Rosenthal DI (eds). Tumors of the Spine: Diagnosis and Clinical Management Philadelphia: WB Saunders Co 1990: 181-191
• 6 Decker R E, Augustin W S, Epstein J A. Spinal epidural venous angioma causing foraminal enlargement and erosion of vertebral body.  J Neurosurg. 1978;  49 605-606
• 7 Dorfman H D, Steiner G C, Jaffe H L. Vascular tumors of bone.  Hum Pathol. 1971;  2 349-376
• 8 Enomoto H, Goto H. Spinal epidural cavernous angioma: MRI finding.  Neuroradiology. 1991;  33 462-467
• 9 Esparza J, Castro S, Portillo J M, Roger R. Vertebral hemangiomas: Spinal angiography and preoperative embolization.  Surg Neurol. 1978;  10 171-173
• 10 Feuerman T, Dwan P S, Young R F. Vertebrectomy for treatment of vertebral hemangioma without preoperative embolization: Case report.  J Neurosurg. 1986;  65 404-406
• 11 Fontaine S, Melanson D, Cosgrove R, Bertrand G. Cavernous hemangiomas of the spinal cord: MR imaging.  Radiology. 1988;  166 839-841
• 12 Fox M W, Onofrio B M. The natural history and management of symptomatic and asymptomatic vertebral hemangiomas.  J Neurosurg. 1993;  78 36-45
• 13 Fukushima M, Nabeshima Y, Shimazaki K, Hirohata K. Dumbbell-shaped spinal extradural hemangioma.  Arch Orthop Trauma Surg. 1987;  106 394-396
• 14 Giombini S, Morello G. Cavernous angiomas of the brain: Account of fourteen personel cases and review of the literature.  Acta Neurochir (Wien). 1978;  40 61-82
• 15 Guthkelch A N. Haemangiomas involving the spinal epidural space.  J Neurol Neurosurg Psychiatry. 1948;  11 199-210
• 16 Heimberger K, Schanaberth G, Koos W, Pendl G, Auff E. Spinal cavernous hemangioma (intradural-extramedullary) underlying repeated subarachnoid haemorrhage.  J Neurol. 1982;  226 289-293
• 17 Hillman J, Bynke O. Solitary extradural cavernous hemangiomas in the spinal canal. Report of five cases.  Surg Neurol. 1991;  36 19-24
• 18 Isla A, Alvares F, Morales C, Blazquez M G. Spinal epidural hemangiomas.  J Neurosurg Sci. 1993;  37 39-42
• 19 Johnston L M. Epidural hemangioma with compression of spinal cord.  JAMA. 1938;  110 119-122
• 20 Kaplan A. Acute spinal cord compression following hemorrhage within extradural neoplasm.  Am J Surg. 1942;  57 450-456
• 21 Kaplan A. Epidural haemangiomaendothelioma.  J Mt Sinai Hosp. 1935;  2 64-67
• 22 Karshner R G, Rand C W, Reeves D L. Epidural haemangioma associated with hemangioma of the vertebrae: Report of a case.  Arch Surg. 1939;  39 942-951
• 23 Lee J P, Wang A DJ, Wai Y Y, Ho Y S. Spinal extradural cavernous hemangioma.  Surg Neurol. 1990;  34 345-335
• 24 Lee K S, Spetzler R F. Spinal cord cavernous malformation in a patient with familial intracranial cavernous malformations.  Neurosurgery. 1990;  26 877-880
• 25 Lindboe C F, Nordal H J. Multiple neurolemmomas of the cauda equina, cavernous hemangioma of the spinal cord, and degeneration of the lateral corticospinal tracts in a man with the clinical diagnoses of multiple sclerosis.  Clin Neuropathol. 1985;  4 260-264
• 26 Linskey M E, Sekhar L N. Cavernous sinus haemangiomas: A series, a review, and an hypothesis.  Neurosurgery. 1992;  30 101-108
• 27 Little J R, Awad I A, Jones S C, Ebrahim Z Y. Vascular pressures and cortical blood flow in cavernous angioma of the brain.  J Neurosurg. 1990;  73 555-559
• 28 McAllister V L, Kendall B E, Bull J WD. Symptomatic vertebral haemangiomas.  Brain. 1975;  98 71-80
• 29 McCormick P C, Michelsen W J, Post K D, Carmel P W, Stein B M. Cavernous malformations of the spinal cord.  Neurosurgery. 1988;  23 459-463
• 30 McCormick W F, Nofzinger J D. “Cryptic” vascular malformations of the central nervous system.  J Neurosurg. 1966;  24 865-875
• 31 McCormick W F. The pathology of vascular (“arteriovenous”) malformations.  J Neurosurg. 1966;  24 807-816
• 32 Meyer F B, Lombardi D, Scheithauer B, Nichols D A. Extra-axial cavernous haemangiomas involving the dural sinuses.  J Neurosurg. 1990;  73 187-192
• 33 Nelson D A. Spinal cord compression due to vertebral angiomas during pregnancy.  Arch Neurol. 1964;  11 408-413
• 34 Numaguchi Y, Kishikava T, Fukui M, Sawada K, Kitamura K, Matsura K, Russel W J. Prolonged injection angiography for diagnosing intracranial cavernous hemangiomas.  Radiology. 1979;  131 137-138
• 35 Padovani R, Tognetti F, Proietti E, Servadei F. Extrathecal cavernous hemangioma.  Surg Neurol. 1982;  18 1463-1465
• 36 Padovani R, Poppy M, Pozzati E, Tognetti F, Querzola C. Spinal epidural hemangiomas.  Spine. 1981;  6 336-340
• 37 Pagni C A, Canavero S, Forni M. Report of a cavernoma of the cauda equina and review of the literature.  Surg Neurol. 1990;  33 124-131
• 38 Perman E. On haemangiomata in the spinal column.  Acta Chir Scand. 1926;  61 91-105
• 39 Pia H W, Djindan R. Spinal Angiomas; Advances in Diagnosis and Therapy. New York: Springer 1978
• 40 Pia H W. Diagnosis and treatment of spinal angiomas.  Acta Neurochir (Wien). 1973;  28 1-12
• 41 Pia H W. Symptomatology of spinal angiomas. In: Pia HW, Djiindan R (eds). Spinal Angiomas: Advances in Diagnosis and Therapy New York: Springer 1978: 48-74
• 42 Ramos Jr F, deToffol B, Aesch B, Jan M. Hydrocephalus and cavernoma of the cauda equina.  Neurosurgery. 1990;  27 139-142
• 43 Rasmussen T B, Kernohan J W, Adson A W. Pathologic classification, with surgical consideration, of spinal tumors.  Ann Surg. 1940;  111 513-530
• 44 Richardson R R, Cerullo L J. Spinal epidural cavernous hemangioma.  Surg Neurol. 1979;  12 266-268
• 45 Rigamonti D, Drayer B P, Johnson P C, Hadley M N, Zabramski J, Spetzler R F. The MRI appearance of cavernous malformations (angiomas).  J Neurosurg. 1987;  67 518-524
• 46 Robinson J R, Award I A. Clinical spectrum and natural course. In: Award IA, Barrow DL (eds). Cavernous Malformations Park Ridge: American Association of Neurological Surgeons 1993: 25-36
• 47 Russel D S, Rubinstein L J. Pathology of tumors of the nervous system. 5^th ed. Baltimore: Williams & Wilkins 1989: 730-736
• 48 Russel D S, Rubinstein L J. Tumor and tumor like lesions of maldevelopmental origin. In: Russel DS, Rubinstein LJ (eds). Pathology of Tumors of the Central Nervous System Baltimore: Williams & Wilkins 1989: 730-736
• 49 Russel D S, Rubinstein L J. Pathology of tumors of the nervous system. 4^th ed. Baltimore: Williams & Wilkins 1977: 129-134
• 50 Scott R M, Barnes P, Kupsky W, Adelman L S. Cavernous angiomas of the central nervous system in children.  J Neurosurg. 1942;  76 38-46
• 51 Simard J M, Garcia-Bengochea F, Ballinger Jr W E, Mickle J P, Quisling R G. Cavernous angioma: A review of 126 collected and 12 new clinical cases.  Neurosurgery. 1986;  18 162-172
• 52 Turner O A, Kernohan J W. Vascular malformations and vascular tumors involving the spinal cord.  Arch Neurol Psychiatr. 1941;  46 444-463
• 53 Tyndel F J, Bilbao J M, Hudson A R. et al . Hemangioma calcificans of the spinal cord.  Can J Neurol Sci. 1985;  12 321-322
• 54 Ueda S, Saito A, Inomori S. et al . Cavernous angioma of the cauda equina producing subarachnoid hemorrhage. Case report.  J Neurosurg. 1987;  66 134-136
• 55 Wood M W, White R J, Kernohan J W. Cavernous haemangiomatosis involving the brain, spinal cord, heart, skin and kidney: Report of case.  Staff Meet Mayo Clin. 1957;  32 249-254
• 56 Wyburn-Mason R. Vascular Abnormalities and Tumors of the Spinal Cord and its Membranes. London: Kimpton 1943: 49-91
• 57 Yamasaki T, Handa H, Yamashita J. et al . Intracranial and orbital cavernous angiomas. A review of 30 cases.  J Neurosurg. 1986;  64 197-208
• 58 Zentner J, Hassler W, Gawehn J. et al . Intramedullary cavernous angiomas.  Surg Neurol. 1989;  31 64-68

Corresponding Author