Intraneural cavernous malformation of the cauda equina

Spinal cavernous angiomas are rare vascular malformations occurring mainly in the vertebral body with or without an extradural extension. Only 3-5% of these lesions are entirely located in the spinal canal where they can occupy an extradural, intradural-extramedullary or intramedullary position. We present a 75-year-old woman with signs and symptoms of multiple lumbar radiculopathy. The lumbosacral MRI showed an intradural cauda equina lesion with heterogeneous contrast enhancement that was subsequently radically removed through an L3-L4 laminectomy. The microscopic appearance was suggestive of cavernous angioma with intraneural growth. Clinical, radiological, and surgical features of this unusual lesion (to date, only 12 cases are reported) are discussed.