Summary
Nine consecutive cases of surgically treated spinal cavernous angiomas are presented. Our series consists of 6 men and 3 women with the following intramedullary spinal location of the cavernomas: 4 cervical, 4 thoracic and 1 thoraco-lumbar. All 9 patients were symptomatic with signs of myelopathy and senorimotor deficits corresponding to the level of the lesion. Six patients underwent laminectomy and in three patients a hemilaminectomy was performed to approach the lesion. A complete resection of the cavernoma was achieved in each case. Five patients showed transient neurological deterioration, in three cases the neurological status remained unchanged, and one patient experienced a slight improvement of symptoms during the early postoperative period. At followup examination (mean 14 months postoperative), a clear improvement of the clinical signs was demonstrable in 6 patients, and a complete resolution of the pre-existing symptoms and signs was achieved in two individuals. In one case the clinical state remained unchanged. It is concluded that microsurgical resection is the treatment of choice in cavernomas of the spinal cord.
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Anson JA, Spetzler RF (1993) Surgical resection of intramedullary spinal cord cavernous malformations. J Neurosurg 78: 446–451
Barnwell SL, Dowd CF, Davis RL, Edwards MSB, Gutin PH, Wilson CB (1990) Cryptic vascular malformations of the spinal cord: diagnosis by magnetic resonance imaging and outcome of surgery. J Neurosurg 72: 403–407
Becker DH, Townsend JJ, Kramer RA, Newton TH (1979) Occult cerebrovascular malformations. A series of 18 histological verified cases with negative angiographs. Brain 102: 249–287
Bertalanffy H, Kühn G, Scheremet R, Seeger W (1992) Indications for surgery and prognosis in patients with cerebral cavernous angiomas. Neurol Med Chir (Tokyo) 32: 659–666
Bertalanffy H, Gilsbach JM, Eggert HR, Seeger W (1991) Microsurgery of deep-seated cavernous angiomas: report of 26 cases. Acta Neurochir (Wien) 108: 91–99
Chiou SM, Eggert HR, Laborde G, Seeger W (1989) Microsurgical unilateral approaches for spinal tumor surgery: eight years' experiences in 256 primary operated patients. Acta Neurochir (Wien) 100: 127–133
Cosgrove GR, Bertrand G, Fontaine S, Robitaille Y, Melanson D (1988) Cavernous angioma of the spinal cord. J Neurosurg 68: 31–36
Fahlbusch R, Strauss C, Huk W, Röcklein G, Kömpf D, Ruprecht KW (1990) Surgical removal of pontomesencephalic cavernous haemangiomas. Neurosurgery 26: 449–457
Fontaine S, Melanson D, Cosgrove R, Bertrand G (1988) Cavernous haemangiomas of the spinal cord: MR imaging. Radiology 166: 839–841
Garner TB, Del Curling O, Kelly DL, Laster DW (1991) The natural history of intracranial venous angiomas. J Neurosurg 75: 715–722
Gilsbach JM, Bertalanffy H (1994) Cavernomas of the basal ganglia, brain stem and spinal cord. Surgical strategy and results. In: Pasqualin A, Da Pian R (eds) New trends in management of cerebro-vascular malformations. Springer, Wien New York, pp 533–537
Giombini S, Morello G (1978) Cavernous angiomas of the brain. Account for fourteen personal cases and review of the literature. Acta Neurochir (Wien) 40: 61–82
Lee KS, Spetzler RF (1990) Spinal cord cavernous malformation in a patient with familial intracranial cavernous malformations. Neurosurgery 26: 887–880
Lopate G, Black JT, Grubb RL (1990) Cavernous haemangiomas of the spinal cord: report of 2 unusual cases. Neurology 40: 1791–1793
Lunardi P, Acqui M, Ferrante L, Fortuna A (1994) The role of intraoperative ultrasound imaging in the surgical removal of intramedullary cavernous angiomas. Neurosurgery 34: 520–523
McCormick P, Michelsen WJ, Post KD, Carmel PW, Stein BM (1988) Cavernous malformations of the spinal cord. Neurosurgery 23: 459–463
Ogilvy CS, Louis DN, Ojemann RG (1992) Intramedullary cavernous angiomas of the spinal cord: clinical presentation, pathological features and surgical management. Neurosurgery 31: 219–230
Pagni CA, Canavero S, Forni M (1990) Report of cavernoma of the cauda equina and review of literature. Surg Neurol 33: 124–131
Rigamonti D, Spetzler RF (1988) The association of venous and cavernous malformations. Report of four cases and discussion of the pathophysiological, diagnostic, and therapeutic implications. Acta Neurochir (Wien) 92: 100–105
Rigamonti D, Drayer BP, Johnson PC, Hadley MN, Zabramski JM, Spetzler RF (1987) The MRI appearance of cavernous malformations (angiomas). J Neurosurg 67: 518–524
Saito N, Yamakawa K, Sasaki T, Saito I, Takakura K (1989) Intramedullary cavernous angioma with trigeminal neuralgia: a case report and review of the literature. Neurosurgery 25: 97–101
Seeger W (1982) Microsurgery of the spinal cord and surrounding structures: anatomical and technical principles. Springer, Wien New York
Simard JM, Garcia-Bengochea F, Ballinger WE, Mickle JP, Quisling RG (1986) Cavernous angiomas: a review of 126 collected and 12 new clinical cases. Neurosurgery 19: 162–172
Vaquero J, Salazar J, Martinez R, Martinez P, Bravo G (1987) Cavernomas of the central nervous system: clinical syndromes, CT scan diagnosis and prognosis after surgical treatment in 25 cases. Acta Neurochir (Wien) 85: 29–33
Vaquero J, Martinez R, Martinez P (1988) Cavernomas of the spinal cord: report of two cases. Neurosurgery 22: 143–144
Veerapen RJ, Sbeih IA, O'Laoire SA (1986) Surgical treatment of cryptic AVMs and associated haematoma in the brain stem and spinal cord. J Neurosurg 65: 188–193
Voigt K, Yasargil MG (1976) Cerebral cavernous haemangiomas or cavernomas. Incidence, pathology, localization, diagnosis, clinical features and treatment. Review of the literature and report of an unusal case. Neurochirurgia (Stuttg) 19: 59–68
Zabramski JM, Wascher TM, Spetzler RF, Johnson B, Golfinos J, Drayer BP, Brown B, Rigamonti D, Brown G (1994) The natural history of familial cavernous malformations: results of an ongoing study. J Neurosurg 80: 422–432
Zentner J, Hassler W, Gawehn J, Schroth G (1989) Intramedullary cavernous angiomas. Surg Neurol 31: 64–68
Zimmerman RS, Spetzler RF, Lee KS, Zabramski JM, Hargraves RW (1991) Cavernous malformations of the brain stem. J Neurosurg 75: 32–39
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Spetzger, U., Gilsbach, J.M. & Bertalanffy, H. Cavernous angiomas of the spinal cord clinical presentation, surgical strategy, and postoperative results. Acta neurochir 134, 200–206 (1995). https://doi.org/10.1007/BF01417690
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DOI: https://doi.org/10.1007/BF01417690