[A clinico radiological study of patients with cavernous angiomas of the spinal cord]. / Estudio clinicorradiológico de pacientes con angiomas cavernosos medulares.

AIM: To define the spectrum of signs, symptoms and radiological features in patients with spinal intramedullary cavernous angioma. We analyze surgical management and clinical follow up in these patients. PATIENTS AND METHODS: 16 adult patients, 9 women and 7 men, were studied in our hospital each with one cavernous angioma of the spinal cord. All patients were diagnosed with magnetic resonance imaging. The lesion location was intramedullary in all patients, 6 patients cervical level and 10 thoracic level. RESULTS: In 12 patients surgical resection of the malformation was performed and histological results confirmed the spinal cavernous diagnostic. In 10 patients, the clinical outcome had improved in Frankel grade. In the four nonoperated cases, successive monitoring studies demonstrated no radiological progression and the clinical symptomatology has remained stable. CONCLUSION: Women in the fertile period appear to be predisposed to develop spinal cavernous angioma. The bleeding risk, in our study, didn t have any relation with CMA level. Magnetic resonance imaging features cannot predict the CMA evolution.

Estudio clinicorradiológico de pacientes con angiomas cavernosos medulares / A clinico-radiological study of patients with cavernous angiomas of the spinal cord

Objetivos. El propósito de este estudio es definir el espectro de síntomas y signos clínicos junto con los hallazgos radiológicos que se presentan en pacientes con cavernomas intramedulares (ACM); se analiza el tratamiento y la evolución clínica en estos pacientes. Pacientes y métodos. Presentamos 16 casos de pacientes, nueve mujeres y siete hombres, con ACM únicos estudiados en nuestro hospital clínicamente, y que se diagnosticaron radiológicamente mediante una resonancia magnética (RM) medular. La localización de las lesiones era en todos los casos intramedular, en seis pacientes en la región cervical, y en 10, en la dorsal. Resultados. Fueron intervenidos 12 de los pacientes. En ellos, se resecó la lesión y se comprobó anatomopatológicamente el diagnóstico de presunción. En cuanto a la evolución clínica posquirúrgica, en 10 mejoró su estado, según la escala de valoración de Frankel. Se ha controlado la evolución de los otros cuatro pacientes, no operados por rechazo voluntario de la intervención, y no se han presentado modificaciones clínicas o radiológicas reseñables. Conclusiones. Encontramos esta patología con mayor frecuencia en mujeres, con inicio de la sintomatología en la edad fértil de la vida. No observamos en nuestra serie una predilección de localización en cuanto al riesgo de sangrado. No hay un patrón de RM claro de predicción evolutiva de los ACM (AU)

Aim. To define the spectrum of signs, symptoms and radiological features in patients with spinal intramedullary cavernous angioma. We analyze surgical management and clinical follow-up in these patients. Patients and methods. 16 adult patients, 9 women and 7 men, were studied in our hospital each with one cavernous angioma of the spinal cord. All patients were diagnosed with magnetic resonance imaging. The lesion location was intramedullary in all patients, 6 patients cervical level and 10 thoracic level. Results. In 12 patients surgical resection of the malformation was performed and histological results confirmed the spinal cavernous diagnostic. In 10 patients, the clinical outcome had improved in Frankel grade. In the four nonoperated cases, successive monitoring studies demonstrated no radiological progression and the clinical symptomatology has remained stable. Conclusion. Women in the fertile period appear to be predisposed to develop spinal cavernous angioma. The bleeding risk, in our study, didn’t have any relation with CMA level. Magnetic resonance imaging features cannot predict the CMA evolution (AU)