Heredia-Gutiérrez Soledad, Carbarín-Carbarín María Eugenia, Heredia-Gutiérrez Antonio
Fomento Económico Mexicano, Clínica de Salud Ocupacional y Bienestar, Servicio de Medicina Laboral. León, Guanajuato, México.
Instituto Mexicano del Seguro Social, Hospital General de Zona No. 20, Servicio de Terapia Intensiva Pediátrica. Puebla, Puebla, México.
Rev Med Inst Mex Seguro Soc. 2024 Jul 1;62(4):1-5. doi: 10.5281/zenodo.11397229.
Cavernous hemangiomas are vascular malformations formed by groups of dilated sinusoids, organized in channels with a single layer of endothelium. Cavernous hemangiomas represent only 3% of all intradural lesions, and of these 5-12 % correspond to spinal cord lesions and those of the cauda equina are rare.
A 57 years-old male patient is presented , without history of radiotherapy, who showed low back pain and contracture of the dorsal and paraspinal muscle during 6 months, evaluated in another hospital and diagnosed with a lumbar disc herniation, he was managed with analgesics and physiotherapy for two months, however the theraphy failed, the symptoms worsened and dysesthesias appeared in the gluteal and perianal region, with reduction of strength in both legs with predominance in the left leg, as well bladder sphincter dysfunction . A simple magnetic resonance imaging of the lumbosacral spine was performed, revealing an intraspinal and intradural lesion at the L1-2 level. He was diagnosed with cauda equina syndrome and surgery was carried out. After surgery the patient presented clinical improvement and resolution of symptoms. During follow-up in the outpatient clinic, one month after surgery, the patient was able to walk independently and is currently asymptomatic. The pathological anatomy result reported a cavernous hemangioma.
Cavernous hemangiomas of the cauda equina are rare, and when they are associated with a cauda equina syndrome, early surgery is recommended like the first option treatment to avoid permanent neurological injury.
海绵状血管瘤是由一组扩张的血窦形成的血管畸形，这些血窦排列成具有单层内皮的通道。海绵状血管瘤仅占所有硬膜内病变的3%，其中5%-12%为脊髓病变，而马尾病变罕见。
一名57岁男性患者，无放疗史，出现腰背痛及背部和椎旁肌挛缩6个月，在另一家医院就诊，诊断为腰椎间盘突出症，接受了两个月的止痛和物理治疗，但治疗失败，症状加重，臀区和肛周出现感觉异常，双腿力量减弱，以左腿为主，同时伴有膀胱括约肌功能障碍。进行了简单的腰骶部脊柱磁共振成像检查，显示L1-2水平有脊髓内和硬膜内病变。诊断为马尾综合征并进行了手术。术后患者临床症状改善，症状消失。术后1个月门诊随访时，患者能够独立行走，目前无症状。病理解剖结果报告为海绵状血管瘤。
马尾海绵状血管瘤罕见，当与马尾综合征相关时，建议早期手术作为首选治疗方法，以避免永久性神经损伤。
