Department of Neurology, Municipal Hospital Affiliated to Taizhou University, Taizhou, 318000, Zhejiang, China.
Department of Neurology, Taiyuan Central Hospital, Shanxi Medical University, No.5, Three Lanes East Road, Taiyuan, 030000, China.
J Med Case Rep. 2024 Nov 20;18(1):555. doi: 10.1186/s13256-024-04885-6.
Cavernous hemangioma is a congenital insidious disease that can occur in any part of the central nervous system. In clinical practice, cavernous hemangioma is mostly found in the brain and rarely in the spinal cord. This study describes a case of a 34-year-old Chinese man of Han ethnicity with lumbar intramedullary cavernous hemangioma. On admission, lumbar intramedullary hemorrhage was observed in the patient, as well as a spindle-shaped hematoma sign was detected on the spinal magnetic resonance imaging. We suspected that the spinal hemorrhage could be associated with spinal cord cavernous hemangioma. The patient was started on dehydration and glucocorticoid therapy of mannitol on the day of admission and was diagnosed with cavernous hemangioma on the basis of his magnetic resonance imaging presentation and spinal cord histopathology results. However, there was no significant improvement in clinical manifestations following conservative treatment. It was exciting that the patient's condition improved after the surgical removal of hematomas.
Clinicians should consider lumbar intramedullary cavernous hemangioma in the differential diagnosis of early spinal cord hemorrhage with a spindle-shaped hematoma sign on the spinal magnetic resonance imaging.
海绵状血管瘤是一种先天性隐匿性疾病，可发生于中枢神经系统的任何部位。在临床实践中，海绵状血管瘤多发生在脑部，很少发生在脊髓。本研究描述了一例汉族 34 岁男性的胸髓内海绵状血管瘤病例。该患者入院时表现为胸髓内髓内出血，脊髓磁共振成像显示梭形血肿征。我们怀疑脊髓出血可能与脊髓海绵状血管瘤有关。该患者入院当天即给予甘露醇脱水和糖皮质激素治疗，并根据磁共振成像表现和脊髓组织病理学结果诊断为海绵状血管瘤。但保守治疗后临床症状无明显改善。令人兴奋的是，血肿清除术后患者病情改善。
对于脊髓磁共振成像显示梭形血肿征的早期脊髓出血，临床医生应考虑胸髓内海绵状血管瘤的鉴别诊断。
