title: Intramedullary vascular lesions in the high cervical region: transoral and dorsal surgical approach. Two case reports.
abstract: Intramedullary vascular malformations in the high cervical region are extremely rare. Two young adult patients with vascular lesions at the level C 2 and 3, and C 2-4 are reported. In one patient selective spinal angiography revealed a combined malformation with a ventral intramedullary arteriovenous angioma and a premedullary aneurysm. This malformation was approached and removed transorally after spondylectomy of C 2. In the second patient MRI and selective angiography showed an intramedullary hemangioblastoma extending from C 2-C 4. After embolization, this lesion was surgically removed via a dorsal approach. Both patients suffered from severe neurological deficits preoperatively. MRI and selective angiography showed the exact locations of the tumors within the spinal cord and indicated a transoral approach in one case and a dorsal approach in the other. After complete obliteration and removal of the lesions, the patients showed no neurological deficits and returned to their previous professions.
authors.affiliation: Neurosurgical Department, General Hospital Heidberg, Hamburg, West Germany.
authors.forename: H
authors.initials: H
authors.lastname: Friedrich
authors.forename: G
authors.initials: G
authors.lastname: Hänsel-Friedrich
authors.forename: H
authors.initials: H
authors.lastname: Zeumer
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae; D005260:Female; D006391:Hemangioma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009493:Neurosurgery / Q000379:methods*; D011859:Radiography; D013120:Spinal Cord Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*