Surgical treatment of intraspinal angiomatous meningiomas from a single center

Intraspinal angiomatous meningiomas (AMs) are rare lesions, and no case series have been reported. We retrospectively reviewed the data of 12 patients with intraspinal AMs. All patients underwent magnetic resonance imaging (MRI) of the spine. Computed tomography angiography was performed for three cases with cervical lesion. The series included six females and six males with a mean age of 49.6 years. Five tumors were located in the cervical, one in the cervicothoracic, five in the thoracic, and one in the thoracolumbar spine. The most common symptom was motor deficits and the mean duration of symptoms was 18 months. All patients were treated surgically with gross total resection (GTR) (Simpson grade I and II resection). No patients underwent embolization. After surgery immediately, the neurological function was improved in five patients, remained stable in six patients, and was deteriorated in one patient. During an average follow up of 78.6 months, 11 patients experienced an improvement in the neurological function and one patient maintained preoperative status. No tumor recurrence was observed on MRI. Compared to conventional meningiomas, AMs have no special clinical and radiological features. The accurate diagnosis depends on pathology. Timely GTR (en bloc resection) is the best treatment and embolization is not necessary for most patients. Radiotherapy is not recommended after GTR (Simpson grade I and II resection), and the risk of tumor recurrence is low.