Thoracic spinal cord cavernous angioma: a case report and review of the literature

Abstract

Introduction: Cavernous angiomas of the spinal cord are rare vascular malformations, which account for approximately 5 to 12 percent of spinal cord vascular lesions. They usually originate in the vertebrae, with occasional extension into the extradural space, and intramedullary cavernomas, even if reported in the literature, are very rare.

Case presentation: We report the case of a 34-year-old Caucasian woman affected by a thoracic intramedullary cavernous angioma. Our patient complained of 10-day history of acute dorsal pain, progressive weakness of both lower extremities, worse on the right side, a 'pins and needles' sensation in the abdominal region and bladder dysfunction. Magnetic resonance imaging showed, at D5 level, a vascular malformation, which was not documented at spinal angiography. Our patient underwent surgical treatment with total removal of the lesion and her symptoms gradually improved. A histological examination revealed the typical features of a cavernous angioma.

Conclusions: Intramedullary cavernous angioma is a rare lesion that should be diagnosed early and surgically treated before rebleeding or enlargement of the lesion can occur.

Figure 1

T1-weighted sagittal magnetic resonance image showing a high signal intensity mass at D5 level.

Figure 2

Intraoperative photograph revealing an intramedullary lesion after myelotomy (a); the lesion was carefully dissected out and removed in one piece (b).

Figure 3

T1-weighted sagittal magnetic resonance image one month later, showing no evidence of residual lesion.