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McQueen SA, Haji FA, Figueroa EL, Sallam Y, Ang LC, Duggal N. Intradural-extramedullary Spinal Cavernoma. Can J Neurol Sci 2023; 50:797-802. [PMID: 36453118 DOI: 10.1017/cjn.2022.287] [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] [Indexed: 12/05/2022]
Affiliation(s)
- Sydney Amelia McQueen
- MD/PhD Program, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Faizal Aminmohamed Haji
- Division of Neurosurgery, Department of Surgery, University of British Columbia, British Columbia. Canada
| | - Enriqueta Lucar Figueroa
- Division of Neurosurgery, Department of Clinical Neurological Sciences, Western University, Ontario, Canada
| | - Yasmine Sallam
- Department of Medical Imaging, Northern Ontario School of Medicine, Health Sciences North, Ontario, Canada
| | - Lee Cyn Ang
- Department of Pathology and Laboratory Medicine, Western University, Ontario, Canada
| | - Neil Duggal
- Division of Neurosurgery, Department of Clinical Neurological Sciences, Western University, Ontario, Canada
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Frank F, Maybaum J, Frydrychowicz C, Stoll K, Gaber K, Meixensberger J. Cervical intradural extramedullary cavernous malformation as a rare cause of subarachnoid hemorrhage without spinal dysfunction: illustrative case. JOURNAL OF NEUROSURGERY: CASE LESSONS 2022; 3:CASE21463. [PMID: 36130539 PMCID: PMC9379632 DOI: 10.3171/case21463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 10/01/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND
Intradural extramedullary cavernoma is a very rare lesion of the spinal cord, especially of the cervical spine. Its clinical presentation can vary with symptoms of sensory or motor deficits and even with symptoms of subarachnoid hemorrhage (SAH).
OBSERVATIONS
The authors present a case of a 45-year-old man with SAH with prolonged neck pain and increasing headache confirmed by lumbar puncture. Head computed tomography revealed only discrete blood deposits in the right frontal and biparietal lobes. The finding of pan-cerebral angiography was negative for the cause of bleeding. Spinal magnetic resonance imaging revealed an intradural extramedullary mass lesion at cervical level C5–6. The finding of subsequent cervical angiography was negative. The diagnosis of a cavernous malformation was confirmed histopathologically after surgery. The cavernoma was completely removed, and full recovery of the initial symptoms was achieved.
LESSONS
Spinal lesions should be considered in the diagnostic work-up for SAH with excluded origin of bleeding in cranial neuroimaging. An intradural extramedullary cavernous malformation is an extremely rare entity in the differential diagnosis of SAH, and surgical resection is the treatment of choice to prevent further bleeding and neurological deficits.
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Affiliation(s)
| | | | | | - Kristin Stoll
- Department of Neurology, University Hospital Leipzig, Leipzig, Germany
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Zakirov BA, Konovalov NA, Belousova OB, Kaprovoy SV. [Surgical treatment of spinal cord cavernous malformations]. ZHURNAL VOPROSY NEĬROKHIRURGII IMENI N. N. BURDENKO 2021; 85:104-113. [PMID: 34156212 DOI: 10.17116/neiro202185031104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Cavernous malformations (CMs) of central nervous system are vascular malformations usually localized in the brain and rarely in the spinal cord. To date, these malformations are well studied. However, some problems of the management of this pathology are still unresolved. This is due to rare localization of intramedullary CMs in the spinal cord and difficult treatment of spinal pathology per se. To date, about 1000 cases of spinal CM are described in the literature. This review is devoted to natural course of disease and postoperative outcomes. These data allow getting a complete picture of modern concepts of the treatment of spinal CMs and formulating the questions requiring further discussion.
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Affiliation(s)
- B A Zakirov
- Burdenko National Medical Research Center of Neurosurgery, Moscow, Russia
| | - N A Konovalov
- Burdenko National Medical Research Center of Neurosurgery, Moscow, Russia
| | - O B Belousova
- Burdenko National Medical Research Center of Neurosurgery, Moscow, Russia
| | - S V Kaprovoy
- Burdenko National Medical Research Center of Neurosurgery, Moscow, Russia
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Golnari P, Ansari SA, Shaibani A, Hurley MC, Potts MB, Kohler ME, Sugrue PA, Jahromi BS. Intradural extramedullary cavernous malformation with extensive superficial siderosis of the neuraxis: Case report and review of literature. Surg Neurol Int 2017; 8:109. [PMID: 28680728 PMCID: PMC5482162 DOI: 10.4103/sni.sni_103_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 05/05/2017] [Indexed: 12/02/2022] Open
Abstract
Background: Spinal cavernous malformations usually affect the vertebral bodies and are seldom intradural. Here, we report a rare spinal intradural-extramedullary cavernous malformation associated with extensive superficial siderosis along the neuraxis in a patient with radicular complaints. Case Description: A 60-year-old male presented with subacute headaches, intermittent fever, and acute back and radicular leg pain for 1–2 weeks. Magnetic resonance imaging revealed an intradural-extramedullary lesion just below the conus medullaris (at the L2 level). There was associated subarachnoid hemorrhage in the lumbar cistern and superficial siderosis along the entire spinal neuraxis. Following surgical resection, the patient's symptoms resolved. Histopathology of the lesion was of a cavernous malformation. Conclusions: There are only 56 cases of spinal intradural-extramedullary cavernous malformations published in the literature; however, only 3 described superficial neuraxis siderosis as noted in this case. In the present case, slowly recurring hemorrhages of the lesion located at the conus likely contributed to the complete neuraxis superficial siderosis. Timely evaluation and treatment of these lesions is warranted to avoid further compressive and/or hemorrhagic complications.
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Affiliation(s)
- Pedram Golnari
- Department of Neurological Surgery and Radiology, Northwestern Memorial Hospital, Chicago, Illinois, USA
| | - Sameer A Ansari
- Department of Neurological Surgery and Radiology, Northwestern Memorial Hospital, Chicago, Illinois, USA
| | - Ali Shaibani
- Department of Neurological Surgery and Radiology, Northwestern Memorial Hospital, Chicago, Illinois, USA
| | - Michael C Hurley
- Department of Neurological Surgery and Radiology, Northwestern Memorial Hospital, Chicago, Illinois, USA
| | - Matthew B Potts
- Department of Neurological Surgery and Radiology, Northwestern Memorial Hospital, Chicago, Illinois, USA
| | - Missia E Kohler
- Department of Neuropathology, Northwestern Memorial Hospital, Chicago, Illinois, USA
| | - Patrick A Sugrue
- Department of Neurological Surgery, Advocate Good Samaritan Hospital, Downers Grove, Illinois, USA
| | - Babak S Jahromi
- Department of Neurological Surgery and Radiology, Northwestern Memorial Hospital, Chicago, Illinois, USA
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Yaltirik K, Özdoğan S, Doğan Ekici I, Atalay B. Cauda equina cavernous hemangioma: very rare pediatric case. Childs Nerv Syst 2016; 32:2289-2291. [PMID: 27796551 DOI: 10.1007/s00381-016-3286-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Accepted: 10/20/2016] [Indexed: 11/24/2022]
Affiliation(s)
- Kaan Yaltirik
- Department of Neurosurgery, Yeditepe University School of Medicine, Icerenkoy Mah. Hastane yolu sok. No: 102/104, 34752 Atasehir-, Istanbul, Turkey.
| | - Selçuk Özdoğan
- Department of Neurosurgery, Yeditepe University School of Medicine, Icerenkoy Mah. Hastane yolu sok. No: 102/104, 34752 Atasehir-, Istanbul, Turkey
| | - Işın Doğan Ekici
- Department of Pathology, Yeditepe University School of Medicine, Icerenkoy Mah. Hastane yolu sok. No: 102/104, 34752 Atasehir-, Istanbul, Turkey
| | - Başar Atalay
- Department of Neurosurgery, Yeditepe University School of Medicine, Icerenkoy Mah. Hastane yolu sok. No: 102/104, 34752 Atasehir-, Istanbul, Turkey
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Baldvinsdóttir B, Erlingsdóttir G, Kjartansson Ó, Ólafsson IH. Extramedullary Cavernous Hemangioma with Intradural and Extradural Growth and Clinical Symptoms of Brown-Séquard Syndrome: Case Report and Review of the Literature. World Neurosurg 2016; 98:881.e5-881.e8. [PMID: 27867117 DOI: 10.1016/j.wneu.2016.11.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 11/03/2016] [Accepted: 11/07/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND Primary spinal tumors are rare. Symptoms depend on the size and location of the tumor. CASE DESCRIPTION A patient presented with a rare clinical finding, Brown-Séquard syndrome. The symptoms were caused by an extramedullary tumor compressing on the thoracic spinal cord. Pathologic examination showed cavernous hemangioma with growth both intradurally and extradurally. CONCLUSIONS This is an extremely rare finding; to our knowledge, only 1 case report has been published before in which a spinal cavernous hemangioma had intradural and extradural growth. The clinical symptoms of Brown-Séquard syndrome have not been described before in the findings of spinal cavernous hemangiomas.
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Affiliation(s)
| | - Gígja Erlingsdóttir
- Department of Pathology, Landspítali University Hospital, Reykjavík, Iceland
| | - Ólafur Kjartansson
- Department of Radiology, Landspítali University Hospital, Reykjavík, Iceland
| | - Ingvar Hákon Ólafsson
- Department of Neurosurgery, Landspítali University Hospital, Reykjavík, Iceland; Faculty of Medicine, University of Iceland, Reykjavík, Iceland
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Kumar V, Nair R, Kongwad LI, Menon R G. Cavernous haemangioma of the cauda region: case report and review of literature. Br J Neurosurg 2016; 31:614-615. [PMID: 27333441 DOI: 10.1080/02688697.2016.1199784] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Cavernomas arising from nerve roots in the cauda quina are extremely rare with less than 30 reported cases in world literature. We report a case of a 21-year old lady with a L3-4 cavernoma successfully managed by surgery thereby adding to the general fund of knowledge on this rare entity.
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Affiliation(s)
- Vinod Kumar
- a Department of Neurosurgery , Kasturba Hospital , Manipal , India
| | - Rajesh Nair
- a Department of Neurosurgery , Kasturba Hospital , Manipal , India
| | | | - Girish Menon R
- a Department of Neurosurgery , Kasturba Hospital , Manipal , India
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Yang T, Wu L, Yang C, Deng X, Xu Y. Cavernous angiomas of the cauda equina: clinical characteristics and surgical outcomes. Neurol Med Chir (Tokyo) 2014; 54:914-23. [PMID: 25367585 PMCID: PMC4533342 DOI: 10.2176/nmc.oa.2014-0115] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Cavernous angioma (CA) is a rare hamartomatous vascular lesion, consisting of abnormal, dilated, and packed sinusoidal vascular channels without interposed nervous tissue. CAs of the cauda equina are exceedingly rare and have been previously reported in the literature as case reports. The aim of this study was to discuss the clinical presentation and the outcomes of microsurgery for these rare lesions. We retrospectively reviewed the records of 10 patients who underwent microsurgery for CAs of the cauda equina. All patients had performed pre- and postoperative magnetic resonance imaging (MRI). CAs of the cauda equina generally exhibited mixed intensity on T1- and T2-weighted images. Contrast-enhanced T1-weighted images showed heterogeneous enhancement. The hemosiderin ring which surrounded the cauda equina CA was rare. Gross total resection was achieved in all cases. All patients were followed up, with a mean duration of 41.1 months. Long-term neurological function was improved in nine patients and remained stable in one patient. No recurrence was observed on MRI. CAs should be considered in the differential diagnosis of cauda equina tumors. Because of the excessive vascularity of CAs, en bloc resection is recommended. For symptomatic patients, early surgery should be performed before neurological deficits deteriorate.
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Affiliation(s)
- Tao Yang
- Department of Neurosurgery, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University
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