SPINAL EPIDURAL CAVERNOUS HEMANGIOMAS - REPORT OF 3 CASES AND REVIEW OF THE LITERATURE

Epidural cavernous hemangiomas are increasingly identified as a cause of acute or chronic progressive spinal cord syndrome and local back pa in or radiculopathy. The authors present three cases of spinal epidura l cavernous hemangiomas manifesting as spinal cord syndrome, thoracic radiculopathy, and lumbar radiculopathy. Based on the imaging characte ristics of these three cases and a review of the literature, the clini cal signs and symptoms and their implications, the role of preoperativ e neuroradiological diagnosis, and the need for complete surgical rese ction are discussed. Epidural cavernous hemangiomas display consistent magnetic resonance imaging properties: T-1-weighted images most commo nly show a homogeneous signal intensity similar to those of spinal cor d and muscle, and contrast enhancement is homogeneous or slightly hete rogeneous. On T-2-weighted images the signal of the lesion is consiste ntly high and slightly less intense than that of cerebrospinal fluid. Frequently, thee lesion is characterized by its extension through the intervertebral foramen. Awareness of these characteristics facilitates diagnosis and treatment of the lesions. Despite the risk of bleeding, in all three cases complete surgical excision was achieved.