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56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

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Symptomatic intramedullary thoracic cavernomas

Symptomatische Kavernome im thorakalen Rückenmark

Meeting Abstract

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  • corresponding author B. Fischer - Klinik und Poliklinik für Neurochirurgie, Universtitätsklinikum Münster
  • S. Palkovic - Klinik und Poliklinik für Neurochirurgie, Universtitätsklinikum Münster
  • L. Lemcke - Klinik und Poliklinik für Neurochirurgie, Universtitätsklinikum Münster
  • T. Niederstadt - Institut für Klinische Radiologie, Universitätsklinikum Münster
  • H. Wassmann - Klinik und Poliklinik für Neurochirurgie, Universtitätsklinikum Münster

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP102

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2005/05dgnc0370.shtml

Published: May 4, 2005

© 2005 Fischer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

Cavernomas of the central nervous system (CNS) occur in up to 1% of the population, mostly intracranially, whereas their spinal location is rather seldom. We present two patients with cavernomas at the same spinal cord level, but with different neurological symptoms and management.

Methods

During the last 8 years 41 patients (30 female, 11 male) with cavernomas of the CNS were treated in our department. 24 cavernomas were found supratentorially, whereas 10 were located infratentorially. In 5 patients multiple lesions, so called cavernomatosis, were diagnosed. In two patients, the symptomatic cavernomas were found within the thoracic spinal cord.

Results

Case 1:

A 56-year-old patient presented 6 years ago with increasing diffuse headache. Computed tomography (CT) showed multiple intracranial cavernomas including the brain stem. Current symtpoms were lumbar back pain and right sided sciatica, without sensory loss or motor weakness. Magnetic resonance imaging (MRI) of the spinal axis showed an additional cavernoma in the thoracic spine at level TH 10, extra-axial and on the right. Unfortunately, the patient did not agree to any kind of surgical intervention.

Case 2:

A 43-year old man with symptoms of a progressive weakness and numbness of the left lower limb and dysaesthesia of the right one. MRI of the spinal axis showed an intramedullary cavernoma at the level TH 9. Somatosensory evoked potential (SSEP) of the tibial nerve revealed a left sided prolonged latency. Microsurgical removal of the cavernoma under continuous SSEP monitoring was complete. Late functional outcome including SSEP patency was good. The clinical symptoms, SSEP and MRI follow-up are uneventful for 8 years.

Conclusions

Intraspinal cavernomas are a rare entity, there are about 200 cases in the literature. According to present experience, symptomatic lesions should be removed totally. As a rule, asymptomatic intraspinal cavernomas or those with the only slight neurological symptoms should not be recommended for surgery because the natural history of such vascular lesions is not yet clear.