Spinal cord compression caused by vertebral hemangioma being symptomatic during pregnancy.
BACKGROUND
Hemangioma is one of the most common benign tumors of the spine, and it remains silent in the vast majority of subjects afflicted. Pregnancy is a known risk factor for symptomatic conversion of the previously silent vertebral hemangiomas. However, the occurrence is rare with only 26 cases reported in the English medical literature.


METHODS
A 22-year-old woman in her 36th week of gestation presented with acute onset of upper back pain and progressive paraplegia. Imaging studies revealed a T4 vertebral hemangioma, which involved the vertebral body, pedincules, transverse, and spinous process with a focal extradural extension of soft tissue component. She underwent emergent cesarean delivery and endovascular embolization, respectively. Her symptoms and neurologic deficits improved quickly. Her complaints restarted 2 years after embolization. Surgical treatment which consists of intraoperative vertebraplasty and segmental fixation was performed. The patient's postoperative recovery was excellent.


CONCLUSIONS
According to literature review and our patient's outcome, pregnancy may induce neurologic symptoms and signs in silent spinal hemangiomas. The way of management is decided by whether the neurologic deficits depend on the deformity caused by hemangioma or some other factors including vascular insufficiency.
Kiroglu
Yilmaz
Y
Department of Radiology, Pamukkale University Medical School, Denizli, Turkey.
Benek
Berk
B
Yagci
Baki
B
Cirak
Bayram
B
Tahta
Kadir
K
D000792:Angiography; D001416:Back Pain / Q000209:etiology; D002585:Cesarean Section; D004621:Embolization, Therapeutic; D005260:Female; D006391:Hemangioma / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D010264:Paraplegia / Q000209:etiology; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000000981:diagnostic imaging / Q000473:pathology*; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods; D012086:Reoperation; D013115:Spinal Canal / Q000000981:diagnostic imaging / Q000473:pathology; D013117:Spinal Cord Compression / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology*; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D013904:Thoracic Vertebrae / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology*; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000295:instrumentation / Q000379:methods; D055815:Young Adult