Recurrent symptomatic vertebral hemangioma in pregnancy managed with decompression and vertebroplasty

Background: Vertebral hemangioma is a benign vascular tumor of the spine that occurs in the endothelial lining of blood vessels. The majority of these lesions are detected incidentally on routine magnetic resonance imaging scans. Rarely, lesions can increase in size and result in neurological deterioration. Case Description: A 19-year-old post-partum female, presented with paraplegia due to a recurrent vertebral hemangioma with exophytic extension into the epidural space resulting in spinal cord compression. Early decompressive surgery facilitated adequate early recovery of neurological function. Conclusion: Exophytic vertebral hemangiomas that have extended into the spinal canal resulting in cord compression require urgent surgical decompression.

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Symptomatic Vertebral Hemangioma in a Young Child

Journal of Neurosciences in Rural Practice ◽

10.4103/jnrp.jnrp_324_16 ◽

2017 ◽

Vol 08 (03) ◽

pp. 458-460

Author(s):

William Martin ◽

Ravi Rajmohan ◽

Muhittin Belirgen

Keyword(s):

Spinal Cord ◽

Rare Case ◽

Tumor Tissue ◽

Pathological Fracture ◽

Cord Compression ◽

Vertebral Hemangioma ◽

Tumor Removal ◽

Vertebral Hemangiomas ◽

Pathological Report

ABSTRACTVertebral hemangiomas (VHs) are the most common benign vertebral neoplasm and typically are asymptomatic, only to be discovered incidentally on imaging from the fourth to fifth decade of life. Seldom do they enlarge to a point of compression, causing pain and focal neurologic deficits. We present the rare case of an 8-year-old female who presented with paraparesis after a fall. Imaging revealed a pathological fracture of the T8 vertebra with retropulsion and spinal cord compression from both fracture and epidural tumor tissue. The patient underwent an anterior and posterior removal of the tumor, decompression, and fusion. Pathological report of specimen biopsy confirmed a benign hemangioma. To the best of our knowledge, this is the same age as the youngest previously reported case of symptomatic VH and it is the longest to be recurrence-free at follow-up. The hemangioma was successfully treated with tumor removal, decompression, and fusion. No adjuvant treatment was required, and she remained asymptomatic without recurrence at her 4-year follow-up.

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Surgical treatment of lumbar canal stenosis with concomitant aggressive vertebral haemangioma

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20202699 ◽

2020 ◽

Vol 6 (4) ◽

pp. 860

Author(s):

Ankur D. Kariya ◽

Pramod A. Jain ◽

Kisan R. Patond

Keyword(s):

Spinal Canal ◽

Vascular Malformations ◽

Rare Condition ◽

Cord Compression ◽

Spinal Canal Stenosis ◽

Vertebral Hemangioma ◽

Canal Stenosis ◽

The Common ◽

Vertebral Hemangiomas ◽

Slow Growing

<p>Vertebral hemangiomas are the most common benign spinal tumours which are asymptomatic, slow-growing benign vascular malformations. They usually involve the vertebral body. However, the involvement of the posterior elements may present with spinal cord compression. Vertebral hemangiomas exist as a continuum of manifestations and lesions ranging from the common asymptomatic forms to rare compressive lesions. Presence of multilevel spinal canal stenosis along with an atypical vertebral hemangioma with cord is a rare condition and represents a treatment challenge. We report a case of spinal canal stenosis at L2 to L4 spinal levels along with an atypical vertebral hemangioma at L3 vertebra with extension to bilateral pedicles. This tumour caused neurological manifestations and was surgically treated with posterior decompression and stabilization with transpedicular screws and rods along with vertebroplasty for the hemangioma. Presence of an atypical hemangioma with co-existing spinal canal stenosis is a rare indication of spinal fusion. Vertebroplasty for the treatment of hemangioma in such cases is imperative.</p>

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Pregnancy-related vertebral hemangioma

Neurosurgical FOCUS ◽

10.3171/foc.2005.19.3.8 ◽

2005 ◽

Vol 19 (3) ◽

pp. 1-7 ◽

Cited By ~ 33

Author(s):

John H. Chi ◽

Geoffrey T. Manley ◽

Dean Chou

Keyword(s):

Spinal Cord ◽

Risk Factor ◽

Surgical Decompression ◽

Neurological Deficits ◽

Vertebral Hemangioma ◽

Review Of The Literature ◽

Treatment Practices ◽

History Of ◽

Spastic Paresis ◽

Vertebral Hemangiomas

Pregnancy is a recognized risk factor for quiescent vertebral hemangiomas becoming symptomatic; this usually occurs during the 3rd month of gestation. The natural history of these lesions is poorly understood, and treatment practices must consider the overall safety of the mother and fetus. The authors report a case of cervical vertebral hemangioma presenting during the 24th week of pregnancy and review the current literature. A 26-year-old woman in her 24th week of pregnancy presented with upper-back pain and progressive spastic paresis in the legs. Neuroimaging studies revealed a diffuse C-7 vertebral body lesion with extradural extension and compression of the spinal cord consistent with a vertebral hemangioma. Successful decompression was accomplished, and the fetus experienced no adverse effects from the surgery. In a review of the literature, 23 cases of pregnancy-related vertebral hemangioma dating back to 1927 were identified. Prepartum surgical decompression was performed in eight patients, postpartum surgery was performed in 12, and surgery was not performed in four. Overall, patients experienced excellent neurological recovery, regardless of the severity and duration of spastic paresis. Observation should be considered for symptomatic patients at greater than 32 weeks gestation. Surgery should be considered for patients with severe neurological deficits at less than 32 weeks of gestation.

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Aggressive Vertebral Hemangioma Causing Recurring Myelopathy – A Rare Case Report and Review of Literature

Journal of Orthopaedic Case Reports ◽

10.13107/jocr.2021.v11.i06.2240 ◽

2021 ◽

Vol 11 (6) ◽

Author(s):

Rohan Bharat Gala ◽

Sanjay B Dhar ◽

Sachin Y Kale ◽

Raja Ganesh ◽

Aditya A Dahapute

Keyword(s):

Case Report ◽

Lower Limb ◽

Arterial Embolization ◽

Surgical Decompression ◽

Vertebral Hemangioma ◽

Left Lower Limb ◽

The Right ◽

Compressive Myelopathy ◽

Vertebral Hemangiomas

Introduction: Vertebral hemangiomas although benign vascular lesions few of these may be ag-gressive causing osseous, extra-osseous and/or epidural expansions with recurrence rate as low as 3%. It should be considered as one of the important differentials while dealing with lytic lesions in the dorsal spine causing compressive myelopathy. Case Report: A 16-year-old female came with an acute history of paraparesis with bladder in-volvement. She was diagnosed of vertebral hemangioma of D9 for which she underwent surgical decompression and fixation. At present, she had paraparesis with a sensory level of D10 on exami-nation. After radiological investigations (X-ray and MRI) she had high intensity signals in the extra osseous portion of D9 with significant neural compression indicating recurrence of vertebral he-mangioma. She underwent decompression with long segment instrumentation with prior arterial embolization. Histopathology features were suggestive of hemangioma and our diagnosis of recur-rence was confirmed. At 2 weeks, the patient had improved neurology with partial sensory recovery and Grade 2 power in the right lower limb and Grade 1 power in the left lower limb. Histopathology report confirmed the diagnosis of hemangioma indicating recurrence. At 6 months follow-up after aggressive rehabilitation, the patient was spastic and improved to Grade 3 power in the left lower limb and Grade 4 power in the right lower limb. The sphincteric control was also found to be fair at 1 year follow-up. Discussion: Vertebral hemangiomas when causing progressive neurological deficit warrant surgical decompression. The choice of intervention depends on location and extent of the tumor. Due to their high vascularity, it is advisable for to preoperatively carry out arterial embolization. Conclusion: Although commonly asymptomatic, vertebral hemangiomas may present as compressive myelopathy. Therefore, they should be detected early, intervened and followed up regularly to detect re

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An Unusual Long Segment Spinal Epidural Cavernous Hemangioma: A Case Report

10.25259/ijmsr_23_2019 ◽

2019 ◽

Vol 1 ◽

pp. 117-120

Author(s):

Shamrendra Narayan ◽

Kuldeep Kumar ◽

Neha Singh ◽

Ragini Singh

Keyword(s):

Cavernous Hemangioma ◽

Histopathological Diagnosis ◽

Review Of Literature ◽

Resonance Imaging ◽

Provisional Diagnosis ◽

Contrast Enhanced ◽

Rare Lesion ◽

Compressive Myelopathy ◽

Vertebral Hemangiomas ◽

Spinal Epidural

Spinal epidural hemangioma, mostly cavernous, is a rare lesion with many radiological mimics that has diagnostic difficulty. They can extend from one to multiple vertebral levels and may or may not be associated with vertebral hemangiomas. We are reporting a case of young adult presenting with features of compressive myelopathy. Plain and contrast-enhanced magnetic resonance imaging showed a large spinal epidural lesion extending from C7 to D10 vertebral levels with extension into adjacent neural foramina and paravertebral spaces. There were also signal changes in bodies and posterior elements of dorsal vertebrae. A provisional diagnosis of lymphoma was made. The patient was operated for decompression and histopathological diagnosis of cavernous hemangioma was made. As in our case, a review of literature shows that epidural cavernous hemangioma of spine may extend to multiple vertebral levels and difficult to diagnose on pre-operative imaging. However, such a long segment epidural cavernous hemangioma has not been reported in literature. Furthermore, we should be aware of these rare lesions to include it in our differential diagnosis the spinal epidural lesions for early diagnosis and management.

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Provocation and prediction of visual peripersonal neglect-like symptoms in preoperative planning and during awake brain surgery

Acta Neurochirurgica ◽

10.1007/s00701-021-04822-2 ◽

2021 ◽

Author(s):

Viktória Tamás ◽

Gabriella Sebestyén ◽

Szilvia Anett Nagy ◽

Péter Zsolt Horváth ◽

Ákos Mérei ◽

...

Keyword(s):

Preoperative Planning ◽

Right Hemisphere ◽

Superior Temporal Gyrus ◽

Low Grade ◽

Navigated Transcranial Magnetic Stimulation ◽

Resonance Imaging ◽

Parietal Area ◽

Routine Magnetic Resonance Imaging ◽

Visuospatial Functions ◽

The Right

AbstractNeglect is a severe neuropsychological/neurological deficit that usually develops due to lesions of the posterior inferior parietal area of the right hemisphere and is characterized by a lack of attention to the left side. Our case is a proven right-handed, 30-year-old female patient with a low-grade glioma, which was located in the temporo-opercular region and also in the superior temporal gyrus of the right hemisphere. Upon presurgical planning, the motor, language, and visuospatial functions were mapped. In order to achieve this, the protocol for routine magnetic resonance imaging and navigated transcranial magnetic stimulation has been expanded, accordingly.

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Pyogenic and tuberculous discitis: magnetic resonance imaging findings for differential diagnosis

Radiologia Brasileira ◽

10.1590/s0100-39842013000300012 ◽

2013 ◽

Vol 46 (3) ◽

pp. 173-177 ◽

Cited By ~ 9

Author(s):

Cristiano Gonzaga de Souza ◽

Emerson Leandro Gasparetto ◽

Edson Marchiori ◽

Paulo Roberto Valle Bahia

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Correct Diagnosis ◽

Cord Compression ◽

Intervertebral Discs ◽

University Hospital ◽

Imaging Findings ◽

Resonance Imaging ◽

Radiographic Findings ◽

Vertebral Bodies

Spondylodiscitis represents 2%–4% of all bone infections cases. The correct diagnosis and appropriate treatment can prevent complications such as vertebral collapse and spinal cord compression, avoiding surgical procedures. The diagnosis is based on characteristic clinical and radiographic findings and confirmed by blood culture and biopsy of the disc or the vertebra. The present study was developed with Clementino Fraga Filho University Hospital patients with histopathologically and microbiologically confirmed diagnosis of spondylodiscitis, submitted to magnetic resonance imaging of the affected regions. In most cases, pyogenic spondylodiscitis affects the lumbar spine. The following findings are suggestive of the diagnosis: segmental involvement; ill-defined abscesses; early intervertebral disc involvement; homogeneous vertebral bodies and intervertebral discs involvement. Tuberculous spondylodiscitis affects preferentially the thoracic spine. Most suggestive signs include: presence of well-defined and thin-walled abscess; multisegmental, subligamentous involvement; heterogeneous involvement of vertebral bodies; and relative sparing of intervertebral discs. The present pictorial essay is aimed at showing the main magnetic resonance imaging findings of pyogenic and tuberculous discitis.

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Tetraplegia after Coronary Artery Bypass Surgery in a Patient with Cervical Herniation

Innovations Technology and Techniques in Cardiothoracic and Vascular Surgery ◽

10.1097/imi.0b013e3181d7553b ◽

2010 ◽

Vol 5 (2) ◽

pp. 134-135 ◽

Cited By ~ 8

Author(s):

Alper Gorur ◽

Numan Ali Aydemir ◽

Nurgül Yurtseven ◽

Mehmet Salih Bilal

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass ◽

Coronary Artery Bypass Surgery ◽

Bypass Surgery ◽

Rare Complication ◽

Artery Bypass ◽

Surgical Decompression ◽

Cervical Disc ◽

Resonance Imaging ◽

Cervical Magnetic Resonance Imaging

Tetraplegia is a rare complication after coronary artery bypass surgery. The authors present a case of tetraplegia after uncomplicated coronary artery bypass surgery because of cervical disc herniation. No distinct abnormality was found in the preoperative neurologic examination although the postoperative cervical magnetic resonance imaging revealed a huge hernia at C5–C6 level presenting with tetraplegia. Surgical decompression was performed on the second postoperative day of bypass surgery, and neurologic deficits gradually improved.

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