ABSTRACT
BACKGROUND: Spinal Cord Intramedullary Cavernoma is a rare disease. It is a vascular disorder composed of capillary-liked vessels without intervening neurons within a spinal lesion. It may only be discovered incidentally or may be diagnosed after a neurologic deficit. Patients may present with weakness which could mimic other neurologic pathology. CASE: A case of a 65 year old with history of hypertension and diabetes mellitus. He had previous microdissectomy of the lumbar L4-L5 disc. He presented with progressive lower leg paresis, urinary retention and obstipation. An MRI revealed a cavernous angioma at the T5 level. CONCLUSION: A multitude of neurologic deficits could lead to a patient presenting with a Spinal Cord Cavernoma. Prompt imaging is warranted in cases presenting with the symptoms to allow appropriate diagnoses and treatment. The clinician must be aware of this rare, but debilitating disease complex.
Subject(s)
Hemangioma, Cavernous, Central Nervous System/diagnosis , Magnetic Resonance Imaging/methods , Spinal Cord Neoplasms/diagnosis , Aged , Diagnosis, Differential , Hemangioma, Cavernous, Central Nervous System/rehabilitation , Humans , Male , Spinal Cord Neoplasms/rehabilitationABSTRACT
Cognitive dysfunction adversely influences long term outcome after cerebral insult, but the potential for brain stem lesions to produce cognitive as well as physical impairments is not widely recognised. This report describes a series of seven consecutive patients referred to a neurological rehabilitation unit with lesions limited to brain stem structures, all of whom were shown to exhibit deficits in at least one domain of cognition. The practical importance of recognising cognitive dysfunction in this group of patients, and the theoretical significance of the disruption of specific cognitive domains by lesions to distributed neural circuits, are discussed.
