Jamal Oufaa, Hmada Saad, Aadoud Khalid, Elbejjaj Iatimad, Elkarkouri Mehdi, Bertal Abderrazak, Lakhdar Abdelhakim
Department, University Hospital Center IBN ROCHD, Casablanca, Morocco.
Ann Med Surg (Lond). 2022 Jun 19;80:104027. doi: 10.1016/j.amsu.2022.104027. eCollection 2022 Aug.
Cavernous hemangiomas are vascular malformations that can affect any part of the central nervous system. In general, epidural hemangiomas are secondary extensions of spinal lesions. These tumors grow slowly and are expressed as slow spinal cord compression syndromes, radiculopathy, or both. History, clinical examination, routine radiographs, MRI, and histopathologic studies are aids to a definitive diagnosis. This is a 61-year-old chronic smoker with a history of cholecystectomy in 2017. History of the disease: dates to 1 month by a progressive installation of heaviness of the left lower limb, then of the right one 15 days later. The state was complicated one week before his admission by sphincter disorders such as urinary leakage. Clinically, the patient walked with assistance, with a paraparesis of the two lower limbs at 4/5 on muscle testing, with a posterior cord syndrome, a D6 sensory level and normal osteotendinous reflexes. Spinal cord MRI showed a tissue-like process at D6-D7 extra-medullary extradural. Spinal cavernous extradural hemangioma is a frequent lesion, represented by a malformation of the microcirculation, whose diagnosis has become easier with the advent of MRI, revealed essentially by a spinal cord compression syndrome, whose evolution is favorable if treated in time.
海绵状血管瘤是一种可影响中枢神经系统任何部位的血管畸形。一般来说，硬膜外血管瘤是脊柱病变的继发性延伸。这些肿瘤生长缓慢，表现为缓慢的脊髓压迫综合征、神经根病或两者兼有。病史、临床检查、常规X线片、磁共振成像（MRI）和组织病理学研究有助于明确诊断。这是一名61岁的长期吸烟者，有2017年胆囊切除术史。疾病史：始于1个月前，左下肢逐渐出现沉重感，15天后右下肢也出现。入院前一周病情因括约肌功能障碍如尿失禁而复杂化。临床上，患者需借助辅助行走，双下肢肌力测试为4/5级轻瘫，伴有后索综合征、D6感觉平面及正常的骨腱反射。脊髓MRI显示在D6 - D7髓外硬膜外有一个组织样病变。脊髓硬膜外海绵状血管瘤是一种常见病变，以微循环畸形为特征，随着MRI的出现其诊断变得更容易，主要表现为脊髓压迫综合征，如果及时治疗其病情发展是有利的。
