Outcome in 53 patients with spinal cord cavernomas.
BACKGROUND
Prevalence of cerebral cavernomas in the general population is close to 0.5%. In contrast, SCCs are rare. The aim of this study was to determine the outcome of SCC in a large sample of patients.


METHODS
Clinical and neuroradiologic findings were retrospectively collected in a multicentric study. Diagnosis was based on pathologic criteria or MR findings.


RESULTS
Fifty-three patients were included (26 males, 27 females). Mean age at onset of symptoms was 40.2 years (11-80 years). Initial symptoms were progressive (32) or acute myelopathy (20). One case was asymptomatic. Triggering factors were found in 14 of the patients (26%). Clinical symptoms were related to spinal cord compression (27) and hemorrhage (22). Spinal cord cavernoma was thoracic in 41 cases and cervical in 12. Mean size of the lesions was 16.3 mm (3-54 mm). In the 40 surgical patients, long-term follow-up was available in 37 cases for a mean time of 7.3 years (0.4-50 years). During the follow-up period, 20 patients improved, 6 remained on their preoperative baseline, and 11 got worse. Surgical improvement was more often found in posterior rather than anterior location. Using McCormick classification, 22 patients were autonomous (grades 1-2), 12 handicapped (grade 3), and 3 bedridden (grade 4) at the end of the follow-up.


CONCLUSIONS
This study has defined clinical and MR patterns of spinal cavernomas. Surgery lastingly improved more than half of the patients.
Labauge
Pierre
P
Service de Neurologie, CHU de Nîmes, 30029 France. labauge@yahoo.fr
Bouly
Stéphane
S
Parker
Fabrice
F
Gallas
Sophie
S
Emery
Evelyne
E
Loiseau
Hugues
H
Lejeune
Jean Paul
JP
Lonjon
Michel
M
Proust
François
F
Boetto
Sergio
S
Coulbois
Sophie
S
Auque
Jean
J
Boulliat
Jacques
J
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D019299:Decompression, Surgical; D042241:Early Diagnosis; D005260:Female; D020786:Hemangioma, Cavernous, Central Nervous System / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D006470:Hemorrhage / Q000209:etiology / Q000473:pathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D011379:Prognosis; D011859:Radiography; D012189:Retrospective Studies; D013115:Spinal Canal / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery; D013116:Spinal Cord / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D013117:Spinal Cord Compression / Q000209:etiology / Q000473:pathology / Q000601:surgery; D013120:Spinal Cord Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome