Spinal Cavernous Malformation

What is it?

Spinal cavernous malformations, also known as Spinal cord cavernous malformations or Spinal cavernomas, is an abnormal collection of tiny blood vessels called capillaries. They can occur anywhere in the body, and in many locations they are harmless, but in the spinal cord they can present a health issue. More than half of spinal cavernomas are located in the thoracic cord. The second most common location is the cervical cord. Spinal cord cavernomas are rare, representing less than 5% of intramedullary lesions in adults. Peak presentation is during the fourth decade, and females are more commonly affected than males.

Symptoms

Episodes of hemorrhage of blood from the spinal cavernous malformations have been proposed as the mechanism underlying acute episodes of neurological deterioration. Common presenting symptoms include pain, weakness, numbness, tingling, or clumsiness in the extremities. Different patterns of clinical presentation are described, with different onset of symptoms, their duration, intensity and termination. Exact symptoms depend on the size, location and hemorrhagic tendency of the cavernous malformation. Progressive myelopathy may be caused by micro hemorrhages.

Diagnosis

Spinal cavernous malformations are best imaged by MRI. These lesions can be seen by CT with hemorrhage in the cord, but smaller lesions may be missed.

Treatment

Early surgical resection should be considered for all symptomatic patients before repeated hemorrhage or enlargement occur. Surgery using an operating microscope and very fine instruments, is the procedure of choice for cavernous malformation removal. They usually can be fully removed with microsurgical techniques.