Fereydonyan Naderafshar, Taheri Morteza, Kazemi Farid
Department of Neurosurgery, Rasool Akram Hospital, Tehran, Iran.
Surg Neurol Int. 2017 Jun 5;8:105. doi: 10.4103/sni.sni_93_17. eCollection 2017.
Pregnancy-related changes can exacerbate the symptoms/signs of vertebral hemangiomas. Here, we report a patient who experienced symptomatic vertebral hemangiomas resulting in cord compression during two consecutive pregnancies.
A 28-year-old female 34 weeks pregnant, presented with a progressive spastic paraparesis. Magnetic Resonance Imaging (MRI) demonstrated an T5 vertebral body signal change attributed to a hemangioma resulting in cord compression. Following a cesarean section, she had a trans thoracic T5 corpectomy with spinal fusion. Indeed, the histopathology was consistent with a vertebral hemangioma. She fully recovered after this first surgery. However, six years later, she again presented with a spastic paraparesis and sphincter deficit now 29 weeks pregnant. The MR demonstrated cord compression one more at the T5 level attributed to the hemangioma; following a T5 and T6 laminectomy, the left paracentral epidural vascular mass totally resected. Her child was successfully delivered 2 months later at which point she exhibited only mild residual lower limb spasticity.
Patients with known vertebral hemangiomas should be closely monitored during pregnancy as increased growth during these pregnancies may result in progressive spinal cord compression.
与妊娠相关的变化可加重椎体血管瘤的症状/体征。在此，我们报告一名患者，其在连续两次妊娠期间出现有症状的椎体血管瘤，导致脊髓受压。
一名28岁、孕34周的女性，表现为进行性痉挛性截瘫。磁共振成像（MRI）显示T5椎体信号改变，归因于血管瘤导致脊髓受压。剖宫产术后，她接受了经胸T5椎体切除及脊柱融合术。组织病理学检查结果确实与椎体血管瘤相符。首次手术后她完全康复。然而，六年后，她再次出现痉挛性截瘫和括约肌功能障碍，此时怀孕29周。磁共振成像显示T5水平再次出现脊髓受压，归因于血管瘤；行T5和T6椎板切除术后，完全切除左侧中央旁硬膜外血管性肿物。两个月后她成功分娩，此时仅表现为轻度残留下肢痉挛。
已知患有椎体血管瘤的患者在妊娠期间应密切监测，因为这些妊娠期间血管瘤生长增加可能导致进行性脊髓受压。
