Coexistence of Intracranial and Spinal Cord Cavernous Malformations Predict Aggressive Clinical Presentation

Abstract

Background: Patients with spinal cord cavernous malformations (CMs) are at increased risk for multiple neuraxis CMs. Few studies focused on the natural history of patients with coexistence of intracranial and spinal cord CMs. Methods: Forty patients who underwent both intracranial and spinal MR imaging from a single center were reviewed retrospectively. American Spinal Injury Association (ASIA) impairment scale was used to evaluate neurological and disability status. Results: The median age of the 40 patients was 40.6 years old (range 9–69), and the male-to-female ratio was 2.1:1. The mean size of the intramedullary lesions was 10.1 ± 5.8 mm (range, 3.0–34.0 mm). Six patients (15%) harbored at least one intracranial lesion. Five of the 6 patients (83.3%) suffered aggressive clinical presentations with severe neurological and disability status; in patients with sporadic spinal CMs, the proportion was 26.5% (9 of 34). Coexistence of intracranial and spinal cord CMs is more likely to follow an aggressive course ( P = 0.031, OR = 19.547, 95% CI = 1.322–289.123). In the postoperative long-term follow up, the unfavorable rate of patients with associated intracranial CMs was significantly higher than that of patients with sporadic spinal cord CMs ( P = 0.049). Conclusions: The prevalence of associated intracranial CMs in patients with spinal cord CMs was 15%. Coexistence of intracranial and spinal cord CMs is more likely to follow an aggressive course. This study highlights the necessity of intracranial MR imaging for patients with spinal cord CMs to benefit to the predicting prognosis and selection of treatment strategies.

Prognosis Analysis and Clinical Features of Orbital Cavernous Venous Malformations With Refractory Insidious Onset

“…Ren Jian (23) reported that patients with cavernous haemangioma (CH) in the spinal canal also have CH of the cranium. However, none of the 35 patients included in the present study had combined CH of the cranium.…”

High Prevalence of Spinal Cord Cavernous Malformations in the Familial Cerebral Cavernous Malformations Type 1 Cohort

“…1,2,4,9 Spinal cord cavernous malformations (SCCMs) are less common than CCMs and have been considered rare, with relatively less attention in the CCM literature and most reported cases being sporadic nonfamilial SCCMs. [10][11][12][13][14][15][16][17][18][19] A 2009 report on a single Italian family with familial CCM found SCCMs in 5 of 12 patients (41.7%), 2 of which were discovered clinically and 3 of which were discovered with screening MR imaging (3 of 6 screened patients had SCCMs). 20 An additional 2017 report on 13 patients with familial CCM found upper SCCMs in 3 patients (23.1%).…”

Intramedullary Spinal Cord Cavernoma: A Case Report and Literature Review

“…10,12 Across 23 literature studies with 825 patients, 671 CMs (81%) were totally resected. 3,7,9,[10][11][12]16,[17][18][19][24][25][26]28,29,32,34,[36][37][38][41][42][43] Transient early postoperative morbidity was reported in 15 out of 116 patients (12%) in 3 series, At the long-term followup 224 patients were improved (27.15%), 393(47.5%) were unchanged, and 72 (8.7%) were worsened, as compared with their preoperative status. These overall results are summarized in Table 2.…”