Surgical Treatment of Intramedullary Spinal Cord Cavernous Malformation

ABSTRACT

OBJECTIVE: Comparing to cerebral cavernoma, spinal intramedullary cavernoma is rare. But, spinal intramedullary cavernomas are increasingly recognized after introduction of magnetic resonance image. The purpose of this study is to define the spectrum of presenting symptoms and signs in patients with intramedullary cavernomas and to analyze the role of surgery as a treatment for these lesions. METHODS: The authors reviewed retrospectively the cases of 13 patients who underwent surgery for intramedullary cavernomas from 1983 to 2001. We investigated demographic findings, history, onset of clinical manifestation, neurological status, radiological findings, operation, and clinical outcome. RESULTS: The mean age was 47 years(range 29-68 years). Among 13 patients, male were 7 cases(54%) and female were 6 cases(46%). Mean duration of symptom were 3.7 years(range 1-20 years). Patients presented three clinical manifestation types. One was acute onset of neurological compromise, the second type was slowly progressive neurological decline, and the third was acute exacerbation during chronic slow decline. Complete surgical removal of the cavernoma was possible in all cases. Mean duration of follow-up was 14.5 months. The surgical outcome were improved(9 cases, 69.2%), same(2 cases, 15.4%), and worse(2 cases, 15.4%). CONCLUSION: Surgical resection is the therapeutic method to restore aggravated neurological status and to halt acute rebleedng and chronic deterioration.