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Vertebral hemangioma presenting with intermittent claudication
M Yazici1, O L Iyigun, B Gulman
1Department of Orthopedics and Traumatology, Faculty of Medicine, Ondokuz Mayis University, Kurupelit, Samsun, Turkey.
Summary
Vertebral hemangiomas can cause rare neurological symptoms like intermittent claudication. Consider this diagnosis for unexplained leg symptoms, as this case demonstrates.
Area of Science:
- Neurology
- Radiology
- Neurosurgery
Background:
- Vertebral hemangiomas are common benign vascular tumors.
- Typically asymptomatic, they can cause neurological deficits via spinal cord compression.
- Extraosseous extension is a key factor in symptomatic presentation.
Observation:
- A patient presented with intermittent claudication, an unusual symptom for vertebral hemangioma.
- Imaging revealed a T5 vertebral hemangioma with extraosseous extension compressing the spinal cord.
- Intermittent symptoms were attributed to gravity-related vascular dilatation causing dynamic cord compression.
Findings:
- Surgical intervention involving subtotal corpectomy, embolization, and spinal fusion was performed.
- The patient experienced complete symptom resolution at a 9-month follow-up.
- This case highlights the potential for vertebral hemangiomas to manifest with atypical neurological complaints.
Implications:
- Vertebral hemangioma should be included in the differential diagnosis for intermittent neurologic symptoms in the lower extremities.
- Understanding the mechanism of dynamic compression is crucial for managing these rare presentations.
- Early diagnosis and appropriate surgical management can lead to favorable patient outcomes.