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Spine

SPINAL CAVERNOMAS

British Association of Spinal Surgeons (BASS)



Abstract

Background

Cavernoma is a benign, cranial vascular hematoma. Spinal cavernomas occur most commonly in vertebrae and may extend into the extradural spinal canal. Intramedullary lesions are rare.

Aim

To study the pattern of clinical presentation and to evaluate their outcome with surgical and conservative management.

Material and Methods

Fourteen cases of intramedullary cavernous malformations were retrospectively reviewed. M/F ratio was 6/8. Age ranged from 35 to 62 years. Thoracic spinal cord was involved in 8, cervical cord in 4 and lumbar region in 2. Nine underwent surgery and 5 were managed conservatively. Clinical, radiological and management features are discussed in the light of the follow-up and literature analysis.

Results

Among the operated patients 6 improved, 3 patients improved but had residual deficits with no improvement in bladder symptoms in one. Patients who were managed conservatively improved over a period of 3 months to 1 year with one patient having residual weakness.

Conclusion

Total surgical resection using microsurgical technique is a procedure of choice for the management of symptomatic intramedullary cavernomas. Clinical observation should be the choice of management for patients without new or progressive neurological deficits. Generally the outlook is good.