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Symptomatic expansile vertebral hemangioma causing conus medullaris compression.
Jeffrey A Rich1, Thomas C Donahue, Timothy J Mick
1Department of Diagnostic Imaging, National University of Health Sciences, Lombard, IL, USA. jrich@nuhs.edu
Journal of Manipulative and Physiological Therapeutics
|April 28, 2005
Summary
A case of symptomatic L1 vertebral hemangioma causing neurologic deficits is presented. Prompt diagnosis with MRI and neurosurgical intervention led to clinical improvement.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Vertebral hemangiomas are benign vascular tumors, typically asymptomatic.
- Expansile vertebral hemangiomas can cause significant neurologic compromise.
Observation:
- A 46-year-old man presented with progressive low back pain and neurologic deficits.
- Magnetic resonance imaging revealed an expansile L1 vertebral hemangioma with an extra-osseous component compressing the conus medullaris.
Findings:
- Conservative chiropractic care provided no relief.
- Neurosurgical intervention resulted in significant clinical improvement.
Implications:
- Physicians should consider rare space-occupying lesions in the differential diagnosis of low back pain with neurologic red flags.
- Magnetic resonance imaging is crucial for diagnosing neurologic abnormalities caused by extradural masses.
- Early recognition and appropriate management of vertebral hemangiomas are essential for favorable outcomes.