Department of Neurosurgery, West China Hospital, Sichuan University, Guo Xue Xiang, Chengdu, China.
Acta Neurochir (Wien). 2012 Apr;154(4):739-45. doi: 10.1007/s00701-012-1295-3. Epub 2012 Feb 25.
Pure epidural cavernous hemangiomas without bony involvement are rare, representing 4% of all spinal epidural tumors. Most of these are case reports and are easily misdiagnosed.
Herein nine patients (male:female, 5:4, average age: 51 years) with symptomatic pure epidural spinal cavernous hemangioma between 2005 and 2011 were treated, and the clinical, radiological, and pathological records, treatment, and prognosis were discussed.
All patients experienced a slowing progressive clinical course, except for one with intralesional hemorrhage. Clinical manifestations included back or radiating pain, sensorimotor deficits, and sphincters disturbance. Eight lesions were isointense on T1- and hyperintense on T2-weighted images with homogenously strongly enhancement and one was mixed signal with heterogeneous enhancement because of intratumoral hemorrhage. Hemilaminotomoy or laminotomy was performed and total resection was achieved. All patients experienced a gradual neurological improvement with no recurrence.
Spinal epidural cavernous hemangioma is a benign vascular malformation that should be excluded in the diagnosis of epidural lesion. Total surgical resection is recommended and usually results in a good prognosis.
无骨累及的单纯硬脊膜外海绵状血管瘤罕见，占所有脊髓硬脊膜外肿瘤的 4%。这些大多是病例报告，容易误诊。
本文回顾性分析 2005 年至 2011 年间收治的 9 例有症状的单纯硬脊膜外脊髓海绵状血管瘤患者的临床、影像学和病理学资料、治疗和预后。
除 1 例伴瘤内出血外，所有患者均表现为进行性缓慢临床病程。临床表现包括背痛或放射痛、感觉运动功能障碍和括约肌功能障碍。8 例病变在 T1 加权像上呈等信号，在 T2 加权像上呈高信号，均匀明显强化，1 例因瘤内出血呈混杂信号，不均匀强化。行半椎板切除术或椎板切除术，全切除肿瘤。所有患者的神经功能逐渐改善，无复发。
脊髓硬脊膜外海绵状血管瘤是一种良性血管畸形，应在硬脊膜外病变的诊断中排除。建议行全切除手术，通常预后良好。
