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Published on: September 7, 2022
Intramedullary spinal cord hemorrhage (hematomyelia)
Andrea N Leep Hunderfund1, Eelco F M Wijdicks
1Department of Neurology, Mayo Clinic College of Medicine, Rochester, MN, USA.
Reviews in Neurological Diseases
|July 10, 2009
Summary
Intramedullary spinal cord hemorrhage, or hematomyelia, is a rare myelopathy. Spinal vascular malformations are the most common cause, with MRI being key for diagnosis.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Intramedullary spinal cord hemorrhage (hematomyelia) is an uncommon cause of myelopathy.
- Spinal vascular malformations (e.g., cavernomas, arteriovenous malformations) are the leading cause of atraumatic hematomyelia.
- Other causes include anticoagulation, bleeding disorders, tumors, metastases, and radiation complications.
Purpose of the Study:
- To review the causes, presentation, diagnosis, and management of intramedullary spinal cord hemorrhage.
- To highlight the importance of prompt diagnosis and identifying the underlying etiology.
Main Methods:
- Literature review of existing studies on intramedullary spinal cord hemorrhage.
- Discussion of clinical presentation, diagnostic imaging, and treatment approaches.
Main Results:
- Hematomyelia presents as various myelopathy syndromes, often with sudden severe back/neck pain and radicular pain.
- Magnetic Resonance Imaging (MRI) with and without gadolinium is the preferred diagnostic modality.
- No clinical trials guide acute hematomyelia management; treatment targets the underlying cause.
Conclusions:
- Prompt recognition of myelopathy symptoms and MRI are crucial for diagnosing hematomyelia.
- Identifying and treating the underlying cause is the primary management strategy in the absence of clinical trials.
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