Nguyen Phi, Huynh Phu An, Ton Nu Tra My, Bui Minh Huynh Quang, Tran Nhu Phuc, Truong Van Tri
Department of Neurosurgery, Vinmec Central Park International Hospital, Ho Chi Minh, Vietnam.
Department of Radiology, Vinmec Central Park International Hospital, Ho Chi Minh, Vietnam.
Surg Neurol Int. 2025 Apr 25;16:152. doi: 10.25259/SNI_227_2025. eCollection 2025.
Intradural extramedullary (IDEM) cavernomas are rare vascular lesions that sometimes needs surgery. However, there has been little information about the surgical strategy for these lesions.
A 39-year-old male presented with 1 month of left lumbosciatalgia. The magnetic resonance imaging was consistent with either an L4 IDEM neurofibroma or a meningioma. At surgery, we encountered a red-oval encapsulated lesion firmly adhered to the L4 nerve root, which was totally excised along with the root itself. Notably, postoperatively, the patient exhibited no new neurological deficit.
IDEM cavernoma is rare but should always be a differential diagnosis for other common IDEM lesions. A total excision of an IDEM cavernoma and sacrification of the involved nerve root seem to be a reasonable option.
硬脊膜内髓外（IDEM）海绵状血管瘤是罕见的血管性病变，有时需要手术治疗。然而，关于这些病变的手术策略的信息很少。
一名39岁男性出现左侧腰骶部疼痛1个月。磁共振成像显示与L4节段的IDEM神经纤维瘤或脑膜瘤相符。手术中，我们遇到一个红色椭圆形包膜病变，牢固地附着于L4神经根，将其与神经根一并完全切除。值得注意的是，术后患者未出现新的神经功能缺损。
IDEM海绵状血管瘤罕见，但对于其他常见的IDEM病变始终应作为鉴别诊断。IDEM海绵状血管瘤的完全切除及受累神经根的牺牲似乎是一个合理的选择。
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