A case of intraroot cauda equina cavernous angioma: clinical considerations

Abstract

Study design: Case report and literature review. Objective: Intradural-extramedullary cavernoma is a rare condition with only 23 cases reported in the literature. Most cases described adhere to spinal root or spinal cord. We report an example of this rare entity located within the sheets of one cauda equina nerve root. Setting: Rome, Italy. Methods: The authors report clinical, radiological, surgical, and pathological features of intraroot cavernoma with a literature review. Results: Patient was operated. One year after surgery, he was healthy. Conclusion: Lumbar intradural cavernous angioma may present with sciatalgia, low-back pain, neurological deficit, or, more rarely with subarachnoid hemorrhage or hydrocephalus. They are treated successfully with surgical resection but preoperative status is a predicting factor for outcome. Sometimes the sacrifice of the spinal root is inevitable because, as in present case, the cavernous angioma is included in the nerve root. These lesions are rare and benign lesions. It is important for neurosurgeons to be aware of the existence of this entity to avoid preoperative misdiagnosis with tumor.

Intradural extramedullary cavernoma of a lumbar nerve root mimicking neurofibroma. A report of a rare case and the differential diagnosis

“…The latter may also be caused by diapedisis hemorrhage [18]. Symptoms include back, neck, and/or spinal pain, sensorimotor deficits, paraparesis, bowel and urinary disturbance, and altered reflexes [2,24,25]. Brown-Sequard syndrome and progressive cord dysfunction are also reported [5,21].…”

“…Magnetic resonance imaging is the imaging modality of choice [23,24] and often the main tool of differential diagnosis [3]. Gadolinium is not always necessary, but it further enhances the imaging of the lesion [3].…”

Clinical characteristics and surgical outcomes of solitary spinal epidural cavernous angiomas

“…An accurate diagnosis depends on pathology. Histologically, CAs must be distinguished from arteriovenous malformations and capillary hemangiomas (27,28). The arteriovenous malformation shows with a cluster of abnormal arteries and veins and vessel walls containing elastin, and smooth muscle (28).…”

Cavernous Angioma of the Cauda Equina: A Case Report and Systematic Review of the Literature

“…23 Cavernous angioma originates from subpial vascular tissue and does not usually contain any nervous tissue. 23 Surgical procedures are technically difficult to perform, due to the formation of dense adhesions between the cavernous angioma and the nerve roots.…”

“…23 Cavernous angioma originates from subpial vascular tissue and does not usually contain any nervous tissue. 23 Surgical procedures are technically difficult to perform, due to the formation of dense adhesions between the cavernous angioma and the nerve roots. In some cases, dissection of the nerve roots that are assumed to be the origin of the mass is unavoidable: nerve roots were resected along with the lesion in seven of the cases reviewed here, 8,12,13,15,17 -19 and paraesthesia or muscle weakness developed in three of these cases.…”