Jacob Kevin Joseph, Rasheed Omar Walid, Abdelaal Ahmed, George K Joshi
Department of Trauma and Orthopaedics, Worcestershire Acute Hospitals NHS Trust, Worcester, GBR.
Department of Neurosurgery, Salford Royal NHS Foundation Trust, Manchester, GBR.
Cureus. 2024 Oct 30;16(10):e72685. doi: 10.7759/cureus.72685. eCollection 2024 Oct.
A 34-year-old female patient, with no comorbidities, presented with complaints of upper back pain across the shoulders, with altered sensation on the left side from trunk to lower limb, which was associated with reduced motor function and an acute symptom of urinary retention. On examination, there was reduced power in the left lower limb, reduced anal tone, a positive Babinski sign bilaterally, and reduced sensation in the perianal region. Serial magnetic resonance imaging (MRI) scans were conducted, where initially an upper thoracic lesion suggestive of an intramedullary cavernoma was found, and nearly a decade later, an adjacent extradural lesion causing cord compression was found incidentally through a surgical procedure. The extradural lesion was removed, and the histology confirmed a cavernoma. In our report, we try to explain a rare case of a patient with co-existing extradural and intradural cavernomas within the spinal cord at different levels. If the patient is symptomatic, a detailed workup plan, along with diagnostic modalities, is needed for further management.
一名34岁女性患者,无合并症,主诉双肩以上上背部疼痛,左侧躯干至下肢感觉改变,伴有运动功能减退和急性尿潴留症状。检查发现左下肢肌力减弱、肛门张力降低、双侧巴宾斯基征阳性、肛周区域感觉减退。进行了系列磁共振成像(MRI)扫描,最初发现上胸段有一个提示髓内海绵状血管瘤的病变,近十年后,通过手术偶然发现一个相邻的硬膜外病变导致脊髓受压。切除了硬膜外病变,组织学检查证实为海绵状血管瘤。在我们的报告中,我们试图解释一例罕见的患者,其脊髓内不同节段同时存在硬膜外和硬膜内海绵状血管瘤。如果患者有症状,进一步的治疗需要详细的检查计划以及诊断方法。