CAVERNOUS ANGIOMA OF THE UPPER CERVICAL SPINAL-CORD - A CASE-REPORT

Study Design, The treatment of a patient with progressive neurologic d eficit secondary to a cavernous angioma located in the dorsal midline of the uppermost cervical spinal cord was described. Objectives, An il lustrative case of a patient with an exophytic cavernous angioma of th e cervical spinal cord near the cervicomedullary junction was presente d, the literature reviewed, and the treatment of these patients discus sed. Summary of Background Data. Cavernous angiomas of the spinal cord were rarely seen, and only more recently appreciated with the advent of MRI scanning. These lesions were usually intramedullary in location . Intradural extramedullary cavernous angiomas, or intramedullary lesi ons with exophytic extramedullary extension, were particularly rare an d usually occurred at the cauda equina. Methods. The surgical treatmen t of a patient with an exophytic cavernous angioma of the upper cervic al spinal cord was presented. Results, This patient underwent surgery after a hemorrhage that occurred after the patient was treated conserv atively for several years. The entire lesion was resected with standar d microsurgical technique, and the neurologic symptoms subsequently re solved. Conclusions, This entity should be suspected in the differenti al diagnosis of patients with progressive and step-wise deterioration of spinal cord function. Although these patients can be treated conser vatively, those with progressive neurologic deficits should undergo mi crosurgical resection to avert subsequent lesion enlargement or repeat ed hemorrhage.