Cavernous angiomas of the spinal cord clinical presentation, surgical strategy, and postoperative results

Nine consecutive cases of surgically treated spinal cavernous angiomas are presented. Our series consists of 6 men and 3 women with the following intramedullary spinal location of the cavernomas: 4 cervical, 4 thoracic and 1 thoraco-lumbar. All 9 patients were symptomatic with signs of myelopathy and senorimotor deficits corresponding to the level of the lesion. Six patients underwent laminectomy and in three patients a hemilaminectomy was performed to approach the lesion. A complete resection of the cavernoma was achieved in each case. Five patients showed transient neurological deterioration, in three cases the neurological status remained unchanged, and one patient experienced a slight improvement of symptoms during the early postoperative period. At follow-up examination (mean 14 months postoperative), a clear improvement of the clinical signs was demonstrable in 6 patients, and a complete resolution of the pre-existing symptoms and signs was achieved in two individuals. In one case the clinical state remained unchanged. It is concluded that microsurgical resection is the treatment of choice in cavernomas of the spinal cord.