Cavernous Angiomas and Arteriovenous Malformations of the Spinal Epidural Space

Abstract

We have retrospectively studied 11 cases of solitary cavernous and arteriovenous malformations of the spinal epidural space. The acute or subacute onset of symptoms was found in all cases, with a neurological deficit in five cases. A plain x-ray study revealed abnormal calcification in one case. Hyperdensity with no iodine enhancement was found on computed tomographic scans in all cases. Magnetic resonance imaging studies showed ovoid or round lesions with isosignal and gadolinium enhancement on T1-weighted images and hypersignal on T2-weighted images, except in one case with hypersignal on T1 and T2 before the administration of a contrast medium. Four lumbar cases were localized in the posterior vertebral ligament; all the thoracic cases were posterior with foraminal extension. The other cases were anterolateral. The surgical findings revealed a dark vascularized epidural lesion associated in two cases with a localized epidural hematoma. A pathological examination revealed seven cavernous angiomas and four arteriovenous malformations. These arteriovenous malformations were all lumbar, and two of four localized within the posterior ligament. The pathophysiology of these vascular malformations is discussed. In light of the good postoperative prognosis of these lesions, surgical removal is recommended for all the symptomatic cases.

Spinal epidural cavernous haemangioma: a case report and review of literature

“…Frequently the lesion is characterized by its extension, into the intervertebral foramen. 9,10,22 The rim of hypointensity resulting from haemosidirin deposits, seen in intramedullary cavernous haemangioma is not seen in epidural cavernous haemangioma. 22,23 These radiological characteristics help to distinguish cavernous haemangiomas from other lesions of the spine.…”

Spontaneous chronic epidural hematoma of the lumbar spine mimicking an extradural spine tumour

“…Other authors estimate that the hematomas come from an arterial source [16]. Graziani et al [17] thought that an epidural cavernous hemangioma could be the cause of some of these spontaneous hematomas.…”

Chronic spontaneous cervicothoracic epidural hematoma in an 8-month-old infant

“…Compared to acute SSEHs, in which surgical decompression must be carried out rapidly,41112 in the rarer chronic SSEHs, the time before decompression procedures are undertaken does not seem to be critical for the recovery of neurological function and, finally, a good clinical outcome. Coz et al13 suggested that spreading of a hematoma remains possible until blood clotting has been completed.…”