TY - JOUR
T1 - Multiple spinal intramedullary cavernous angiomas with bleeding episode mimicking an intramedullary tumor
AU - Utomo, Sri Andreani
AU - Bajamal, Abdul Hafid
AU - Yueniwati, Yuyun
AU - Parenrengi, Muhammad Arifin
AU - Fauziah, Dyah
N1 - Publisher Copyright:
© 2022, EduRad. All rights reserved.
PY - 2022/3
Y1 - 2022/3
N2 - Intramedullary cavernous angioma is a rare vascular malformation compared to cerebral cavernous malformation. The incidence of cavernous angioma is about 3-5% of all central nervous system lesions, 5-12% of all spinal vascular lesions, and 1% of all intramedullary lesions in pediatric patients. Although intramedullary cavernous angioma has the same histological picture as cerebral cavernous angioma, the natural history, and surgical approach are different from cerebral cavernous angioma. Due to its location in the eloquent area of the spinal medulla, a slight change in the size of the lesion can affect the neurological function of the patient. We describe a case of an intramedullary cavernous angioma with hemosiderin post bleeding, located in the cervical cord which was initially misdiagnosed as hemorrhagic ependymoma. On whole spine MR imaging we also found an intramedullary cavernous angioma in the lower thoracal cord at the T12 level with mild hemorrhage. Abdominal MRI showed cavernous angiomas in both kidneys. The patient underwent surgical treatment with removal of the lesion in the cervical cord and T12 level, with histopathologic findings consistent with cavernous angioma. No malignancy was detected. Post-surgery, the symptoms gradually improved. Symptomatic intramedullary cavernous angioma tends to bleed repeatedly and being unstable. Early diagnosis and surgical treatment can prevent rebleeding and more severe symptoms.
AB - Intramedullary cavernous angioma is a rare vascular malformation compared to cerebral cavernous malformation. The incidence of cavernous angioma is about 3-5% of all central nervous system lesions, 5-12% of all spinal vascular lesions, and 1% of all intramedullary lesions in pediatric patients. Although intramedullary cavernous angioma has the same histological picture as cerebral cavernous angioma, the natural history, and surgical approach are different from cerebral cavernous angioma. Due to its location in the eloquent area of the spinal medulla, a slight change in the size of the lesion can affect the neurological function of the patient. We describe a case of an intramedullary cavernous angioma with hemosiderin post bleeding, located in the cervical cord which was initially misdiagnosed as hemorrhagic ependymoma. On whole spine MR imaging we also found an intramedullary cavernous angioma in the lower thoracal cord at the T12 level with mild hemorrhage. Abdominal MRI showed cavernous angiomas in both kidneys. The patient underwent surgical treatment with removal of the lesion in the cervical cord and T12 level, with histopathologic findings consistent with cavernous angioma. No malignancy was detected. Post-surgery, the symptoms gradually improved. Symptomatic intramedullary cavernous angioma tends to bleed repeatedly and being unstable. Early diagnosis and surgical treatment can prevent rebleeding and more severe symptoms.
KW - bleeding episode
KW - cavernoma
KW - cavernous angioma
KW - intramedullary
KW - magnetic resonance imaging
UR - http://www.scopus.com/inward/record.url?scp=85129654802&partnerID=8YFLogxK
U2 - 10.3941/jrcr.v16i3.4251
DO - 10.3941/jrcr.v16i3.4251
M3 - Article
C2 - 35529426
AN - SCOPUS:85129654802
SN - 1943-0922
VL - 16
SP - 15
EP - 22
JO - Journal of Radiology Case Reports
JF - Journal of Radiology Case Reports
IS - 3
ER -