Department of Neurosurgery, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
Department of Neurosurgery, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India,
Pediatr Neurosurg. 2020;55(4):210-214. doi: 10.1159/000509164. Epub 2020 Sep 7.
Cavernous malformation (CM) of the pediatric spine is uncommon, and its presentation especially in infancy is extremely rare. We report an unusual case of thoracolumbar intramedullary CM with hemorrhage in a 5-month-old male child.
The child presented with the predominant symptom of urinary retention, and the underlying neurological cause was initially overlooked. However, magnetic resonance imaging obtained after the onset of progressive limb weakness revealed a D11-L1 intramedullary lesion with features of intralesional bleed. Intraoperatively, the lesion showed evidence of hemorrhage and was completely excised. The final histopathology confirmed a cavernoma.
Although rare, spinal CM can present with bleed in very young children. It is imperative to identify the subtle clinico-radiological findings and suspect such lesions, as an early treatment portends a good outcome.
儿童脊柱海绵状血管畸形（CM）并不常见，尤其是在婴儿期，其表现极其罕见。我们报告一例 5 个月大男性患儿胸腰椎髓内 CM 伴出血的不常见病例。
患儿主要表现为尿潴留，最初未发现潜在的神经原因。然而，在进行性肢体无力发作后进行的磁共振成像显示 D11-L1 髓内病变，具有瘤内出血的特征。术中，病变显示有出血迹象，并被完全切除。最终的组织病理学证实为海绵状血管瘤。
虽然罕见，但脊髓 CM 可在非常年幼的儿童中发生出血。至关重要的是要识别出细微的临床-影像学发现并怀疑存在此类病变，因为早期治疗预示着良好的结果。
