Conus medullaris hematomyelia associated with an intradural-extramedullarycavernous angioma

A unique case of a 50-year-old woman with a conus medullaris hematomyelia a ssociated with a low thoracic intradural-extramedullary cavernous angioma l ocalized 2 cm above is reported. The patient had a 2-month history of progr essive paraparesis, hypoesthesia of legs, and bowel and bladder disturbance s. The symptoms worsened acutely during the last days before admission. A t horaco-lumbar MRI showed a space-occupying lesion at T10-T11 (vertebral int erspace associated with a hematomyelia localized about 2 cm below. A T10-L1 laminectomy was performed and complete removal of both lesions was obtaine d with microsurgical technique. A non-traumatic hematomyelia should always prompt the suspicion of a spinal AVM or, more rarely, of a cavernous angioma. The possible anatomical and c linical correlations of this unusual association are discussed.