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Epidural spinal cavernous hemangioma

R Padolecchia¹, G Acerbi, M Puglioli

¹Section of Neuroradiology, Santa Chiara Hospital, Pisa University, Italy.

|June 6, 1998

Summary

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Magnetic resonance imaging (MRI) findings for rare epidural spinal cavernous hemangiomas vary based on degenerative changes. Mixed signal intensity on MRI may indicate this vascular malformation, aiding surgical planning.

Area of Science:

Neurology
Radiology
Pathology

Background:

Epidural spinal cavernous hemangiomas are rare vascular malformations within the central nervous system.
Accurate correlation between MRI appearances and histologic findings for these specific lesions is not well-documented.

Observation:

Five cases of epidural spinal cavernous hemangioma underwent MRI and surgical resection.
MRI sequences included T1-, proton density-, and T2-weighted imaging, with gadolinium enhancement in most cases.
Computed tomography was also used in two cases.

Findings:

MRI revealed mixed low- and high-signal intensity in two cases, correlating with degenerative changes and hemosiderin.
The remaining three cases showed low/intermediate T1 and high T2/PD signals, without degenerative changes or hemorrhage.

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All patients achieved significant improvement after laminectomy and microsurgical resection.

Implications:

MRI appearance of epidural spinal cavernous hemangioma likely depends on the presence of degenerative phenomena and hemosiderin.
Mixed signal intensity across all MRI sequences may suggest cavernous hemangioma.
Preoperative diagnosis can potentially lead to less invasive surgical approaches.