1RESUMO -O hemangioma cavernoso intramedular é anomalia vascular de baixo fluxo, curável através de ressecção cirúrgica. Entretanto, se não forem instituídos o diagnóstico precoce e a terapêutica adequada, pode levar à graves sequelas neurológicas. É extremamente raro a ocorrência de um angioma cavernoso intramedular. É relatado o caso de uma paciente de 33 anos, com um angioma cavernoso intramedular no nível de T6 -T7, que apresentava quadro clínico de compressão medular lenta e progressiva, com piora recente importante. A ressonância magnética da coluna torácica demonstrou, entre a sexta e a sétima vértebras dorsais, lesão expansiva intramedular que se apresentava hipointensa em T1 e discretamente hiperintensa em T2, com pequeno halo hipointenso à sua volta nas duas sequências. A paciente foi submetida a tratamento cirúrgico tardio e não apresentou recuperação neurológica. Os achados clínicos, de imagem e a importância de instituir precocemente o tratamento adequado são analisados e discutidos.PALAVRAS-CHAVE: angioma cavernoso, cavernoma, intramedular, malformação vascular, hemangioma cavernoso.Spinal cord intramedullary cavernous haemangioma: case report Spinal cord intramedullary cavernous haemangioma: case report Spinal cord intramedullary cavernous haemangioma: case report Spinal cord intramedullary cavernous haemangioma: case report Spinal cord intramedullary cavernous haemangioma: case report ABSTRACT -The intramedullary cavernous haemangioma is a low flow vascular anomaly curable through surgical resection, howewer if the precocious diagnosis and the appropriate therapeutics are not done it can cause serious neurological sequels.It is extremely rare the occurrence of intramedullary cavernous haemangioma. We report the case of a 33 year-old woman patient with an intramedullary cavernous angioma at T6-T7, that presented a clinical picture of slow and progressive spinal cord compression , with an important recent worsening.The magnetic resonance of the thoracic column demonstrated a T6 -T7 a intramedullary expansive lesion wich presented hypointense on T1 and discretely hyperintense on T2 with a small hypointense area in the two sequences.The patient was submitted to late surgical treatment and did not presented neurological recovery. The clinical and imagelogy pictures, and the importance of instituing precociously the appropriate treatment of this entity is reviewed, analyzed and discussed.KEY WORDS: cavernous angioma, cavernoma, intramedullary vascular malformation, cavernous haemangioma.Serviço de Neurocirurgia do Hospital Santa Casa Misericórdia de Pelotas, RS, Brasil (UCPE). Hemangiomas cavernosos são malformações vasculares que ocorrem no tecido nervoso 1,2 . E quando intramedulares são classicamente descritas como raras 3 . Malformações cavernosas espinhais ocorrem usualmente nas vértebras e podem se estender para dentro do canal medular extradural 4 . Cavernoma extradural e intradural já foram relatados. No presente relato, descrevemos um caso de angioma cavernoso, revisamos a literatura relaciona...
Submit Manuscript | http://medcraveonline.com asosseptal flap has been used to permitlong-termpatency of drainage site [4]. Material and MethodsA 43years old man presented with 6 month history of intermittent right hemicranial headache and ipsilateral conductive hearingloss. The patient had no historyof head trauma. The MRI demonstrated a large and expansile right petrous apex lesion hyper intense on both T1-and T2-weighted scans, without diffusion restriction or internal contrast enhancement. The CT scan showed and expansile and lyticlesion with surrounded bony erosion (Figures 1-4). Surgical techniqueA medial and unilateral trans sphenoidal trans clival approach with internal carotidartery lateralization combined with transpterygoidinfrapetrous approach was indicated because of the location of the lesion. Team surgery is mandatory when there is manipulation of the internal carotid artery and a risk of vascular injury [5]. Bilateral sphenoidotomies provides more room for instrumentation and allow four-hand surgery by a team of surgeons an otolaryngology and a neurosurgeon, however unilateral sphenoidotomie approach can be a viable option and less invasive alternative. The sinonasal mucosa was de congested with topical epinephrine 1:2000. The partial Volume
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