Acute presentation of spinal epidural cavernous angiomas: case report.
OBJECTIVE
Spinal extramedullary hematomas stemming from cavernous angiomas in the epidural compartment are rare. It is more common for spinal epidural cavernous angiomas to present with slow and progressive myelopathy or radiculopathy. They seldom present with clinical evidence of acute spinal cord or nerve root compression.


METHODS
Three consecutive cases of acute spinal cavernous angiomas with overt neurological deficits were presented. These presentations included acute onset of neck pain and tetraparesis, bilateral lower extremity pain and paraparesis, and acute sciatic pain with plantar flexor weakness. The lesions were located in the cervical, thoracic, and sacral spine, respectively. The cases included either abrupt lesion enlargement secondary to a pure intralesional hemorrhage or a cavernous hemorrhage that invaded the epidural space.


METHODS
All patients were treated with either laminotomy or complete resection of the hematoma and cavernoma within 12 hours after admission.


CONCLUSIONS
Spontaneous spinal epidural hematomas presented with significant pain and acute spinal cord and nerve root compression may represent the manifestation of a cavernous angioma. Appropriate interpretation of preoperative imaging studies may prevent delay in proper management, especially for patients in whom nerve root deficit is the only clinical expression.
Caruso
Giuseppe
G
Division of Neurosurgery, Villa Maria Cecilia Hospital, Cotignola, Italy.
Galarza
Marcelo
M
Borghesi
Ignazio
I
Pozzati
Eugenio
E
Vitale
Mario
M
D000208:Acute Disease; D000328:Adult; D000368:Aged; D003422:Critical Care / Q000379:methods; D015174:Epidural Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D006392:Hemangioma, Cavernous / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D007796:Laminectomy; D008159:Lumbar Vertebrae; D008297:Male; D016896:Treatment Outcome