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Dorsal foramenal extraosseous epidural cavernous hemangioma
Giancarlo D'Andrea1, Orlando Epimenio Ramundo, Giuseppe Trillò
1Department of Neurological Sciences, University, Rome, Italy. gdandrea2002@yahoo.it
Neurosurgical Review
|October 2, 2003
Summary
Cavernous hemangiomas are rare spinal tumors. This case highlights an extradural, extramedullary cavernous hemangioma and its successful microsurgical removal, emphasizing accurate MRI diagnosis to differentiate from spinal neurinoma.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Cavernous hemangiomas are vascular malformations affecting the central nervous system, commonly found in the brain but rarely in the spine.
- Spinal cavernous hemangiomas can occur in intramedullary or extramedullary epidural locations.
Observation:
- A 52-year-old woman presented with symptoms suggestive of a D3 spinal root lesion.
- Initial radiological diagnosis indicated a foramenal neurinoma, but heterogeneous MR signals prompted consideration of cavernous hemangioma.
- The lesion was an extradural, extramedullary cavernous hemangioma with dorsal foramenal extension.
Findings:
- The patient underwent microsurgical treatment using a far lateral extraforamenal approach.
- Post-surgery, the patient experienced rapid symptom improvement, with resolution of pain and dysesthesia.
- Complete lesion removal was achieved without compromising the posterior spinal structures.
Implications:
- Accurate magnetic resonance imaging (MRI) is crucial for differentiating spinal cavernous hemangiomas from other spinal tumors like neurinomas.
- Microsurgical techniques, such as the far lateral extraforamenal approach, offer effective treatment for these lesions.
- Early diagnosis and surgical intervention can lead to significant neurological recovery.