Article

CT findings of a thoracic vertebral hemangioma presenting with acute neurological symptoms.

Ankara Ataturk Education and Research Hospital, Department of Radiology, Ankara, Turkey.
Turkish neurosurgery (Impact Factor: 0.58). 01/2011; 21(1):113-5.
Source: PubMed

ABSTRACT Vertebral body hemangiomas are benign lesions and account for 4% of all spinal tumors. The most common histological type is cavernous hemangioma. These tumors generally locate in the vertebral body as a solitary lesion. Multiple lesions are seen in approximately 25-30% of vertebral hemangiomas. Mostly they are asymptomatic and incidentally found with radiological studies. Symptomatic vertebral hemangiomas are rare and represent < 1% of all hemangiomas; however, if untreated, they may cause local or radicular pain and neurological deficits ranging from myeloradiculopathy to paralysis. In this case we aim to present preoperative and postoperative Computed Tomography findings of a cavernous hemangioma that caused sudden motor deficit and was localised to the thoracic vertebra corpus and posterior elements.

0 Bookmarks
 · 
421 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Fifty-nine cases of vertebral hemangioma were seen at the Mayo Clinic between 1980 and 1990. Vertebral hemangiomas were discovered incidentally in 35 patients, while pain was the presenting complaint in 13 patients. Five patients presented directly with progressive neurological deficit requiring surgery, and six patients had surgery elsewhere for spinal cord compression and were referred for follow-up evaluation. To better define the natural history of these lesions, a historical review of these patients was conducted; progression of an asymptomatic or painful lesion to neurological symptoms was found in only two cases (mean follow-up period 7.4 years, range 1 to 35 years). New-onset back pain followed by subacute progression (mean time to progression 4.4 months, range 0.25 to 12 months) of a thoracic myelopathy was the most common presentation for patients with neurological deficit. Initially, all 11 patients with spinal cord compression underwent decompressive surgery with full neurological recovery. Recurrent neurological symptoms were observed in three of six patients following subtotal tumor resection and postoperative administration of 1000 cGy or less radiation therapy (mean follow-up period 8.7 years, range 1 to 17 years). No recurrences were noted in four patients who had subtotal excision plus radiotherapy between 2600 and 4500 cGy. One other patient had gross total tumor removal without radiotherapy and has not had a recurrence. Based on these patients and a review of the literature, the authors recommend annual neurological and radiological examinations for patients with hemangiomas associated with pain, especially young females with thoracic lesions in whom spinal cord compression is most likely to develop. Radiation therapy or embolization is an effective therapeutic alternative for patients with severe medically refractory pain. Regular follow-up monitoring for patients with asymptomatic lesions is unnecessary unless pain develops at the appropriate spinal level. It is concluded that management of patients with a progressive neurological deficit should include preoperative angiography and embolization, decompressive surgery with the approach determined by the degree of vertebral involvement and site of spinal cord compression, and postoperative radiation therapy in patients following subtotal tumor removal. Operative management and complications are discussed.
    Journal of Neurosurgery 02/1993; 78(1):36-45. · 3.15 Impact Factor
  • Source
    Proceedings (Baylor University. Medical Center) 08/2002; 15(3):325-6.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Pregnancy related compressive myelopathy secondary to vertebral hemangioma is a rare occurrence and its treatment antepartum is rare. We report a 22-year-old lady in her 26th-week of pregnancy who was treated in two stages--antepartum with a laminectomy and posterior stabilization. This resulted in complete recovery of the neurological deficits. She delivered a normal baby after 3 months, following which a corpectomy and fusion was performed. This two-staged approach appears safe and effective in treating symptomatic vertebral haemangiomas causing neurological deficits during pregnancy. A review of relevant literature has been done.
    European Spine Journal 02/2008; 17 Suppl 2:S299-303. · 2.47 Impact Factor

Full-text (2 Sources)

View
17 Downloads
Available from
May 27, 2014