spinal_cord_cavernoma_clinical_features

Spinal cord cavernoma clinical features

Unlike their intracranial counterpart, spinal cord cavernomas are more likely to give rise to significant neurological findings and are associated with mass effect, myelopathy, hemorrhage and significant morbidity 1) 2) 3) 4).

The clinical presentation varies depending on site, with the thoracic (58%) and cervical (38%) spinal cord being the most frequent locations 5) 6).

Most patients present with progressive neurological decline, with sensory deficits and motor weakness being the most common presenting symptoms 7) 8).

The mean incidence of symptomatic presentation and diagnosis is usually in the 3rd to 4th decade of life and the clinical presentation includes two primary patterns: slow-progressive and acute neurological decline, with the former being more common 9)10) 11) 12).

Although rare, spinal CM can present with bleed in very young children. It is imperative to identify the subtle clinico-radiological findings and suspect such lesions, as an early treatment portends a good outcome 13).

References

1)
Lu DC, Lawton MT. Clinical presentation and surgical management of intramedullary spinal cord cavernous malformations. Neurosurg Focus 2010;29:E12.
2) , 5) , 7) , 10)
Babu R, Owens TR, Karikari IO, et al. Spinal cavernous and capillary hemangiomas in adults. Spine (Phila Pa 1976) 2013;38:E423-30.
3)
Hegde A, Mohan S, Tan KK, et al. Spinal cavernous malformations: magnetic resonance imaging and associated findings. Singapore Med J 2012;53:582-6.
4)
Bian LG, Bertalanffy H, Sun QF, et al. Intramedullary cavernous malformations: clinical features and surgical technique via hemilaminectomy. Clin Neurol Neurosurg 2009;111:511-7.
6) , 8) , 11)
Gross BA, Du R, Popp AJ, et al. Intramedullary spinal cord cavernous malformations. Neurosurg Focus 2010;29:E14.
9)
See-Sebastian EH, Marks ER. Spinal cord intramedullary cavernoma: A case report. W V Med J 2013;109:28-30.
12)
Liang JT, Bao YH, Zhang HQ, et al. Management and prognosis of symptomatic patients with intramedullary spinal cord cavernoma: clinical article. J Neurosurg Spine 2011;15:447-56.
13)
Gendle C, Salunke P, Karthigeyan M, Gupta K. Spinal Cavernoma in an Infant: A Rare Pathological Entity with an Atypical Presentation [published online ahead of print, 2020 Sep 7]. Pediatr Neurosurg. 2020;1-5. doi:10.1159/000509164
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