Intramedullary spinal cord hemangioma: A rare case report

Spinal cord hemangiomas are rare vascular malformations that can cause neurological deficits. We report a case of a 57-year-old male who previously underwent spondylolisthesis reduction for treatment of a 30% (1 cm) anterolisthesis of L4-L5 with continued neurological deficit post-operatively. The patient still reported bilateral lower extremity weakness, and he was found to have an additional ovoid intramedullary lesion at the T2-T3 level, pathologically consistent with a hemangioma. The patient underwent a T2-T3 laminectomy, and the lesion was resected without any complications. Histopathological examination confirmed the diagnosis of hemangioma. Postoperatively, the patient showed significant improvement in his lower extremity weakness and back pain. Hemangiomas are rare lesions that account for less than 5% of all spinal cord tumors. They consist of vessels similar to those of embryonic capillaries and can cause pressure on the surrounding neural tissue, leading to neurological deficits. MRI is the imaging modality of choice for diagnosing spinal cord hemangiomas. Hemangiomas typically demonstrate mixed signal intensities on T1-weighted images, depending on the fat content of the lesion. They usually demonstrate high T2 signal intensity due to high water content, and avid contrast enhancement due to high vascularity. Surgical resection is the treatment of choice for symptomatic hemangiomas, and complete resection is associated with a good prognosis.