Department of Neurosurgery, Shanghai Institute of Neurosurgery, Changzheng Hospital, Naval Medical University, Shanghai 200003, PR China; Department of Neurosurgery, Jiangnan University Medical Center, Wuxi 214002, PR China.
Department of Neurosurgery, Shanghai Institute of Neurosurgery, Changzheng Hospital, Naval Medical University, Shanghai 200003, PR China.
Clin Neurol Neurosurg. 2024 Nov;246:108527. doi: 10.1016/j.clineuro.2024.108527. Epub 2024 Sep 3.
Intradural capillary hemangioma is a rare condition with unclear etiology. Although intradural capillary hemangiomas are benign, they exhibit significant proliferative activity, and their clinical significance should not be underestimated.
We report a series of spinal intradural capillary hemangiomas to illustrate the characteristics, surgical management, and outcomes.
A total of 18 consecutive patients who underwent microsurgical treatment were retrospectively reviewed. Patient characteristics were recorded in each case, including presenting symptoms, imaging findings, neurologic status, a surgical procedure performed and follow-up.
There were 11(61.1 %) male and 7(38.9 %) female patients, with the ages ranging from 25 to 62 years. The thoracic spine was the most commonly affected site, accounting for 77.8 % (14/18) of the cases. 9 tumors were identified as intradural extramedullary, 3 tumors as intramedullary, and 2 tumors as both extramedullary and intramedullary. There were also 4 cases of tumors localized to the cauda equina. Clinical presentations included back pain, sensory deficits, weakness and gait ataxia with a duration of symptoms ranging from 1 to 12 months. The lesion was hypointense or isointense with the spinal cord on T1- weighted images and hyperintense on T2-weighted images and showed intense enhancement after contrast medium injection. All patients underwent surgical treatment, and no significant postoperative complications were observed. Postoperatively, patients were followed up for an average of 44 months. Follow-up showed that the majority of patients experienced significant improvement in neurological function, with no cases of recurrence.
Surgical resection is typically the preferred method for treating spinal intradural capillary hemangiomas. Complete resection can relieve spinal cord compression and minimize the risk of recurrence.
硬脊膜内毛细血管血管瘤是一种病因不明的罕见疾病。虽然硬脊膜内毛细血管血管瘤是良性的，但它们表现出明显的增殖活性，其临床意义不应被低估。
我们报告了一系列脊髓硬脊膜内毛细血管血管瘤病例，以说明其特征、手术治疗和结果。
回顾性分析了 18 例接受显微手术治疗的连续患者。记录了每位患者的特征，包括症状、影像学表现、神经状态、手术方式和随访。
男 11 例（61.1%），女 7 例（38.9%），年龄 25～62 岁。胸段最常受累，占 77.8%（14/18）。9 例肿瘤为硬脊膜外髓内，3 例肿瘤为髓内，2 例肿瘤为髓内外。还有 4 例肿瘤位于马尾。临床表现包括背痛、感觉缺失、无力和步态共济失调，症状持续时间 1～12 个月。病变在 T1 加权图像上呈低信号或等信号，在 T2 加权图像上呈高信号，注射造影剂后呈明显强化。所有患者均行手术治疗，无明显术后并发症。术后随访平均 44 个月。随访发现，大多数患者神经功能明显改善，无复发病例。
手术切除是治疗脊髓硬脊膜内毛细血管血管瘤的首选方法。完全切除可解除脊髓压迫，降低复发风险。
