Román-de Aragón María, Márquez Trinidad, Isla Alberto, Gómez-de la Riva Alvaro
Servicio de Neurocirugía, Hospital Universitario La Paz, Madrid, España.
Servicio de Neurocirugía, Hospital Universitario La Paz, Madrid, España.
Neurocirugia (Astur). 2014 Nov-Dec;25(6):286-9. doi: 10.1016/j.neucir.2014.06.005. Epub 2014 Sep 6.
Hemangioblastomas are benign hypervascular tumours, which are frequently located at the posterior fossa or the spinal cord. Nerve root hemangioblastomas account for less than 2% of total cases. Sometimes the initial diagnosis can be inaccurate and the final diagnosis is not reached until the surgical procedure is performed. Given the high vascularisation of this particular kind of tumour, preoperative embolisation of the tumour is recommended to reduce surgical bleeding and minimise the risk of injuries to motor nerve roots. In this particular case, the patient presented with radicular pain in the right L4 nerve root territory originated by a radicular extraforaminal hemangioblastoma. After tumour devascularization and under neurophysiological control, total excision of lesion was achieved without posterior neurological deficit.
血管母细胞瘤是良性高血管性肿瘤,常位于后颅窝或脊髓。神经根血管母细胞瘤占总病例数的不到2%。有时初始诊断可能不准确,直到进行手术才得出最终诊断。鉴于这类肿瘤血管高度丰富,建议对肿瘤进行术前栓塞以减少手术出血,并将运动神经根损伤风险降至最低。在这个特殊病例中,患者表现为右L4神经根区域的神经根性疼痛,由椎间孔外神经根血管母细胞瘤引起。在肿瘤去血管化并在神经生理监测下,实现了病变的完全切除,且未出现术后神经功能缺损。