Yamamoto Junkoh, Takahashi Mayu, Akiba Daisuke, Soejima Yoshiteru, Nakano Yoshiteru, Aoyama Yuichi, Korogi Yukunori, Nishizawa Shigeru
Department of Neurosurgery, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyusyu 807-8555, Japan.
Spine J. 2009 May;9(5):e10-3. doi: 10.1016/j.spinee.2008.08.012. Epub 2008 Oct 14.
Hemangioblastomas in the central nervous system are highly vascular lesions, but have low risk of hemorrhage. In spinal lesions, there are a few rare cases of intramedullary hemorrhages associated with hemangioblastoma, and their prognoses were very severe.
This is the first case of an intrasyrinx hemorrhage associated with hemangioblastoma in epiconus. We report this rare case and discuss the clinical manifestations of intrasyrinx hemorrhage caused by hemangioblastoma in epiconus.
A case report.
This case report presents a 45-year-old woman with intrasyrinx hemorrhage caused by hemangioblastoma in epiconus. The patient presented with a sudden onset of burning bilateral leg pain and rectal/bladder dysfunction, indicating conus medullaris syndrome. Initial magnetic resonance imaging revealed an intramedullary nodular lesion in the epiconus and holocord syringomyelia. However, follow-up magnetic resonance imaging showed intramedullary hemorrhage.
The patient underwent surgery, and an intrasyrinx hematoma was evacuated and the tumor was completely removed. Histological diagnosis was hemangioblastoma. Three months after surgery, the patient recovered from neurological deficits.
We present this rare case, and emphasize hemangioblastoma as the differential diagnosis in hemorrhagic spinal lesion.
中枢神经系统的血管母细胞瘤是血管丰富的病变,但出血风险较低。在脊髓病变中,有少数与血管母细胞瘤相关的髓内出血罕见病例,其预后非常严重。
这是第一例发生在圆锥部与血管母细胞瘤相关的脊髓空洞内出血病例。我们报告这一罕见病例,并讨论圆锥部血管母细胞瘤引起的脊髓空洞内出血的临床表现。
病例报告。
本病例报告介绍了一名45岁女性,因圆锥部血管母细胞瘤导致脊髓空洞内出血。患者突然出现双侧腿部灼痛和直肠/膀胱功能障碍,提示圆锥马尾综合征。最初的磁共振成像显示圆锥部有一个髓内结节性病变和全脊髓空洞症。然而,后续的磁共振成像显示有髓内出血。
患者接受了手术,清除了脊髓空洞内的血肿并完全切除了肿瘤。组织学诊断为血管母细胞瘤。术后三个月,患者从神经功能缺损中恢复。
我们呈现了这一罕见病例,并强调血管母细胞瘤是出血性脊髓病变的鉴别诊断之一。