Surgical management of spinal cord cavernoma

Three cases of surgically verified intramedullary cavernous angioma (cavernoma) of the spinal cord are reported. Intramedullary cavernomas of the cord are quite uncommon and account for between 3 and 12% of all vascular lesions of the spinal cord. Little is known of their natural history, although their tendency to produce haemorrhage and episodic symptomatic worsening is recognized. Our series includes one male and two females whose ages ranged between 31 and 67 years. The most common presenting symptom was pain, which in all cases preceded weakness. In two of our cases, the typical progression of sudden paroxysmal worsening of symptoms accompanied by pain was noted. This was thought to be related to bleeding in the lesion. In this series, an average of 8 years had elapsed after the onset of symptoms before the patients came to surgery. Standard microsurgical technique facilitated removal of the lesions, following which all patients regained preoperative function.