Tehran University of Medical Sciences, Children?s Medical Center Hospital, Department of Pediatric Neurosurgery, Tehran, Iran.
Turk Neurosurg. 2023;33(5):912-915. doi: 10.5137/1019-5149.JTN.41154-22.2.
Spinal intramedullary capillary hemangioma is a rare condition. Although most spinal/spinal cord hemangiomas are inborn in origin, perinatal presentation is uncommon. We present a neonate with an intramedullary hemangioma, born with communicating hydrocephalus and complete paraplegia. Spinal imagining showed an intradural mass with hemorrhagic foci, a low-lying conus medullaris, and scalloping of dorsal elements. Ventriculoperitoneal shunting was performed in an emergent setting, with cerebrospinal fluid showing a brownish appearance with high viscosity which implied a possible old hemorrhage. Tissue sample was taken from the spinal lesion in an elective setting. Histopathological examination revealed capillary lobules and extralobular large vessels resembling abnormal veins. The mentioned clues suggested that this congenital hemangioma had become symptomatic from the prenatal period. Though it is a are event, it should be kept in mind while evaluating a neonate with communicating hydrocephalus and weakness of extremities with or without cutaneous hemangiomatous stigmata.
脊髓髓内毛细血管瘤是一种罕见的疾病。尽管大多数脊髓/脊髓血管瘤是先天起源的，但围产期表现并不常见。我们介绍了一例新生儿患有髓内血管瘤，出生时伴有交通性脑积水和完全截瘫。脊髓成像显示硬膜内肿块伴有出血灶、脊髓圆锥位置低和背侧骨元素呈扇贝状。在紧急情况下进行脑室-腹腔分流术，脑脊液呈棕色，黏度高，提示可能有陈旧性出血。在选择性设置下从脊髓病变处采集组织样本。组织病理学检查显示毛细血管小叶和小叶外大血管类似于异常静脉。上述线索表明，这种先天性血管瘤从产前就已经出现症状。虽然这是一种罕见事件，但在评估伴有或不伴有皮肤血管瘤体征的交通性脑积水和四肢无力的新生儿时，应该记住这一点。
