Acute compressive myelopathy due to vertebral haemangioma.
A 47-year-old woman with a history of anaemia presented to the emergency room with an acute onset of leg weakness. Physical examination of the bilateral lower extremities was significant for 0/5 muscle strength in all muscle groups with decreased pinprick and temperature sensation. A sensory level at the umbilicus was appreciated. Fine touch and proprioception were preserved. Bowel and bladder function were intact. CT revealed several thoracic, vertebral haemangiomatas. An MRI was suggestive of an epidural clot at the T8-T10-weighted posterior epidural space. At the level of the lesion, the cerebrospinal fluid space was completely effaced, and the flattened spinal cord exhibited signs of oedema and compressive myelopathy. The patient immediately underwent surgical decompression of the spinal cord. An epidural clot and vessel conglomeration were identified. A postoperative spinal angiogram confirmed the diagnosis of vertebral haemangioma. At 1-month follow-up, the patient regained strength and sensation.
Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Mohamed
M
Macki
Mohamad
M
Bydon
Paul
P
Kaloostian
Ali
A
Bydon
D019299:Decompression, Surgical; D003937:Diagnosis, Differential; D005260:Female; D006391:Hemangioma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010264:Paraplegia / Q000209:etiology; D013117:Spinal Cord Compression / Q000209:etiology* / Q000601:surgery; D013125:Spinal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed