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de Almeida RAA, Tatsui CE. Commentary on "Surgical Outcomes of Symptomatic Intramedullary Spinal Cord Cavernous Malformations: Analysis of Consecutive Cases in a Single Center". Neurospine 2023; 20:822-823. [PMID: 37798976 PMCID: PMC10562246 DOI: 10.14245/ns.2346902.451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
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Tawil ME, Chryssikos T, Rechav Ben-Natan A, Ambati VS, Guney E, Shah V, Abla AA, Mummaneni PV. Resection of a Thoracic Intradural Extramedullary Cavernoma Using Real-Time Intraoperative Ultrasound: 2-Dimensional Operative Video. Oper Neurosurg (Hagerstown) 2023; 25:e174. [PMID: 37306964 PMCID: PMC10637418 DOI: 10.1227/ons.0000000000000786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 04/06/2023] [Indexed: 06/13/2023] Open
Affiliation(s)
- Michael E. Tawil
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA
| | - Timothy Chryssikos
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA
| | - Alma Rechav Ben-Natan
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA
| | - Vardhaan S. Ambati
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA
| | - Ekin Guney
- Department of Pathology, University of California San Francisco, San Francisco, California, USA
| | - Vinil Shah
- Department of Radiology, University of California San Francisco, San Francisco, California, USA
| | - Adib A. Abla
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA
| | - Praveen V. Mummaneni
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA
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Izi Z, El Haddad S, Allali N, Chat L. Spinal Cord Cavernous Malformation: A Case Report. Glob Pediatr Health 2023; 10:2333794X231184317. [PMID: 37434870 PMCID: PMC10331179 DOI: 10.1177/2333794x231184317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 07/13/2023] Open
Abstract
Spinal cord cavernous malformation is a rare and uncommon vascular malformation, it may remain asymptomatic for a long period or manifest as a sudden or gradual change in spinal cord functioning. The diagnosis relies essentially on magnetic resonance imaging (MRI). Surgery constitutes the majority of management with all the complications that can occur during and after surgery. We report a case of intramedullary cavernoma of a 12-year-old patient admitted for acute paraparesia with bowel and bladder dysfunction. MRI revealed 2 intramedullary cavernomas at T6-T7 and T11-T12. Through this case report, we discuss the clinical and radiological characteristics of this unusual intramedullary malformation.
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Rauschenbach L, Santos AN, Engel A, Olbrich A, Benet A, Li Y, Schmidt B, Gembruch O, Özkan N, Jabbarli R, Wrede KH, Siegel A, Lawton MT, Sure U, Dammann P. Functional neurological outcome of spinal cavernous malformation surgery. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:1714-1720. [PMID: 36928489 DOI: 10.1007/s00586-023-07640-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/14/2023] [Accepted: 03/05/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE Spinal cavernous malformations (SCM) present a risk for intramedullary hemorrhage (IMH), which can cause severe neurologic deficits. Patient selection and time of surgery have not been clearly defined. METHODS This observational study included SCM patients who underwent surgery in our department between 2003 and 2021. Inclusion required baseline clinical factors, magnetic resonance imaging studies, and follow-up examination. Functional outcome was assessed using the Modified McCormick scale score. RESULTS Thirty-five patients met the inclusion criteria. The mean age was 44.7 ± 14.5 years, and 60% of the patients were male. In univariate analysis, the unfavorable outcome was significantly associated with multiple bleeding events (p = .031), ventral location of the SCM (p = .046), and incomplete resection (p = .028). The time between IMH and surgery correlated with postoperative outcomes (p = .004), and early surgery within 3 months from IMH was associated with favorable outcomes (p = .033). This association remained significant in multivariate logistic regression analysis (p = .041). CONCLUSIONS Removal of symptomatic SCM should be performed within 3 months after IMH when gross total resection is feasible. Patients with ventrally located lesions might be at increased risk for postoperative deficits.
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Affiliation(s)
- Laurèl Rauschenbach
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany.
- Center for Translational Neuroscience and Behavioral Science (C-TNBS), University of Duisburg-Essen, Essen, Germany.
| | - Alejandro N Santos
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany
- Center for Translational Neuroscience and Behavioral Science (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Adrian Engel
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany
- Center for Translational Neuroscience and Behavioral Science (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Angelina Olbrich
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany
- Center for Translational Neuroscience and Behavioral Science (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Arnau Benet
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, USA
| | - Yen Li
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - Börge Schmidt
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen, Germany
| | - Oliver Gembruch
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany
- Center for Translational Neuroscience and Behavioral Science (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Neriman Özkan
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany
- Center for Translational Neuroscience and Behavioral Science (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Ramazan Jabbarli
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany
- Center for Translational Neuroscience and Behavioral Science (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Karsten H Wrede
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany
- Center for Translational Neuroscience and Behavioral Science (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Adrian Siegel
- Department of Neurology, University Hospital Zurich, Zurich, Switzerland
| | - Michael T Lawton
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, USA
| | - Ulrich Sure
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany
- Center for Translational Neuroscience and Behavioral Science (C-TNBS), University of Duisburg-Essen, Essen, Germany
| | - Philipp Dammann
- Department of Neurosurgery and Spine Surgery, University Hospital Essen, Essen, Germany
- Center for Translational Neuroscience and Behavioral Science (C-TNBS), University of Duisburg-Essen, Essen, Germany
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