Vicenty Juan C, Fernandez-de Thomas Ricardo J, Estronza Samuel, Mayol-Del Valle Miguel A, Pastrana Emil A
Department of Surgery, Neurosurgery Section, University of Puerto Rico, Medical Science Campus, San Juan, Puerto Rico.
Asian J Neurosurg. 2019 Jul-Sep;14(3):1033-1036. doi: 10.4103/ajns.AJNS_249_18.
Intradural extramedullary spinal cavernous malformations (CMs) remain the least common variant of these lesions and can originate from the inner surface of the dura mater, the pial surface of the spinal cord, and the blood vessels in the spinal nerves. Root-based-only extramedullary CMs are very rare in the thoracic region with only four cases reported. We present a case of 56-year-old male with 1-year progression of lower extremities weakness. Magnetic resonance imaging demonstrated a hyperintense lesion in the upper thoracic region. Surgical exploration revealed a CM with origin in the second thoracic nerve root with gross total resection. Histopathological examination confirmed a CM. The patient had complete recovery of neurological function at 3 months interval. Intradural extramedullary CM is extremely rare entity that must be considered in the differential diagnosis of intradural extramedullary lesions. Surgical resection is the treatment of choice to prevent further neurological damage.
硬脊膜内髓外脊髓海绵状畸形(CMs)仍然是这些病变中最不常见的类型,可起源于硬脑膜内表面、脊髓软膜表面以及脊神经中的血管。仅累及神经根的髓外CMs在胸段非常罕见,仅有4例报道。我们报告一例56岁男性,下肢无力进展1年。磁共振成像显示上胸段有一个高信号病变。手术探查发现一个起源于第二胸神经根的CM,并进行了全切。组织病理学检查证实为CM。患者在3个月时神经功能完全恢复。硬脊膜内髓外CM是一种极其罕见的疾病,在硬脊膜内髓外病变的鉴别诊断中必须予以考虑。手术切除是预防进一步神经损伤的首选治疗方法。