Spinal and paraspinal giant cervical cavernous malformation with postpartum presentation.

Area of Science:

• Neurology
• Neurosurgery
• Radiology

Background:

• Cavernous malformations (CMs) are vascular anomalies typically found in the central nervous system (CNS).
• Spinal CMs are significantly less common than intracranial CMs.
• Their presentation can vary, but aggressive, tumor-like appearances are unusual.

Observation:

• A case of a giant, intradural extramedullary CM originating from a cervical nerve root is presented.
• The lesion exhibited invasive characteristics, extending into paraspinal tissues, epidural space, and bone.
• It encased critical neurovascular structures including cervical nerve roots, brachial plexus, and the vertebral artery.

Findings:

• Histological examination confirmed the lesion as an intraneural cavernous malformation.
• The CM presented with imaging features suggestive of an aggressive, expansive tumor.
• The patient became symptomatic during the puerperal period.

Implications:

• This case highlights the potential for spinal CMs to present as aggressive, tumor-like lesions.
• Successful gross-total resection was achieved through staged surgical interventions, including dural reconstruction and spinal stabilization.
• Understanding the diverse presentations of spinal CMs is crucial for accurate diagnosis and effective management.