Skip to main content
PMC home page
European Spine Journal logoLink to European Spine Journal
. 1997 Sep;6(5):298–303. doi: 10.1007/BF01142674

Cavernous angiomas of the spinal district: surgical treatment of 11 patients

R Padovani 1,✉, N Acciarri 1, M Giulioni 1, R Pantieri 2, M P Foschini 3
PMCID: PMC3454601  PMID: 9391798

Abstract

Cavernous angiomas, also called cavernous malformations or cavernomas, are vascular hamartomas accounting for 3–16% of all angiomatous lesions of the spinal district. Although histologically identical, these vascular anomalies may exhibit different clinical behavior and radiological features, depending on their location, hinting at different managements and therapeutic approaches. The authors report 11 cases of symptomatic spinal cavernous angiomas diagnosed and surgically treated over the past 18 years. Age of patients ranged from 15–75 years; males outnumbered females. Three patients had vertebral cavernous malformations, secondarily invading the epidural space; two had pure epidural lesions; two patients had intradural extramedullary lesions, and four intramedullary lesions. Surgical removal was completely achieved in four patients with intramedullary lesions, in two with subdural extramedullary lesions, and in one with a pure epidural lesion. Subtotal excision of another one epidural and three vertebral cavernous angiomas was followed by radiotherapy. There was no morbidity related to surgery; the mean follow-up was 2 years. The outcome was excellent in two cases, good in six, and unchanged in the other three. The authors discuss the different modalities of treatment of these vascular lesions variously placed along the spine.

Key words: Cavernous angioma, Cavernous malformation, Cavernoma, Spine, Surgical treatment

Full Text

The Full Text of this article is available as a PDF (935.6 KB).

References

  • 1.Acciarri N, Padovani R, Pozzati E, Gaist G, Manetto V. Spinal cavernous angioma: a rare cause of subarachnoid hemorrhage. Surg Neurol. 1992;37:453–456. doi: 10.1016/0090-3019(92)90134-9. [DOI] [PubMed] [Google Scholar]
  • 2.Acciarri N, Padovani R, Giulioni M, Gaist G. Surgical treatment of spinal cavernous angiomas. J Neurosurg Sci. 1993;37:209–215. [PubMed] [Google Scholar]
  • 3.Anson JA, Spetzler RF. Surgical resection of intramedullary spinal cord cavernous malformations. J Neurosurg. 1993;78:446–451. doi: 10.3171/jns.1993.78.3.0446. [DOI] [PubMed] [Google Scholar]
  • 4.Barrow DL, Awad IA (1993) Conceptual overview and management strategies. In: Awad IA, Barrow DL (eds) Cavernous malformations. American Association of Neurological Surgeons Park Ridges, pp 205–213
  • 5.Bartels RHMA, Grotenhuis JA, Spek JAN. Symptomatic vertebral hemangiomas. J Neurosurg Sci. 1991;35:187–192. [PubMed] [Google Scholar]
  • 6.Feider HK, Yuille D. An epidural cavernous hemangioma of the spine. AJNR. 1991;12:243–244. [PMC free article] [PubMed] [Google Scholar]
  • 7.Fontaine S, Melanson D, Cosgrove R, Bertrand G. Cavernous hemangiomas of the spinal cord: MR imaging. Radiology. 1988;166:839–841. doi: 10.1148/radiology.166.3.3340780. [DOI] [PubMed] [Google Scholar]
  • 8.Fox MW, Onofrio BM. The natural history and management of symptomatic and asymptomatic vertebral hemangiomas. J Neurosurg. 1993;78:36–45. doi: 10.3171/jns.1993.78.1.0036. [DOI] [PubMed] [Google Scholar]
  • 9.Gordon CR, Crockard HA, Symon L. Surgical management of spinal cord cavemoma. Br J Neurosurg. 1995;9:459–464. doi: 10.1080/02688699550041098. [DOI] [PubMed] [Google Scholar]
  • 10.Graziani N, Bouillot P, Figarella-Branger D, Dufour H, Peragut JC, Grisoli F. Cavernous angiomas and arteriovenous malformations of the spinal epidural space: report of 11 cases. Neurosurgery. 1994;35:856–864. doi: 10.1227/00006123-199411000-00009. [DOI] [PubMed] [Google Scholar]
  • 11.Harrison MJ, Eisenberg MB, Ullman JS, Oppenheirn JS, Camins MB, Post KD. Symptomatic cavernous malformations affecting the spine and spinal cord. Neurosurgery. 1995;37:195–205. doi: 10.1227/00006123-199508000-00002. [DOI] [PubMed] [Google Scholar]
  • 12.Hemmy DC. Vertebral hemangiomas. In: Wilkins RH, Rengachary SS, editors. Neurosurgery, vol 1. New York: McGraw Hill; 1985. pp. 1076–1079. [Google Scholar]
  • 13.Hillman J, Bynke O. Solitary extradural cavernous hemangiomas of the spinal canal. Report of five cases. Surg Neurol. 1991;36:19–24. doi: 10.1016/0090-3019(91)90127-u. [DOI] [PubMed] [Google Scholar]
  • 14.Isla A, Alvarez F, Morales C, Blazques MG. Spinal epidural hemangiomas. J Neurosurg Sci. 1993;37:39–42. [PubMed] [Google Scholar]
  • 15.Jellinger K. Pathology of spinal vascular malformations and vascular tumors. In: Pia HW, Djindjian R, editors. Spinal angiomas. Advances in diagnosis and therapy. New York: Springer; 1978. pp. 13–20. [Google Scholar]
  • 16.Laredo D-L, Reizine D, Bard M, Metland J-J. Vertebral hemangiomas: radiological evaluation. Radiology. 1986;161:183–189. doi: 10.1148/radiology.161.1.3763864. [DOI] [PubMed] [Google Scholar]
  • 17.Lee J-P, Wang A D-J, Wai Y-Y, Ho YO. Spinal extradural cavernous hemangioma. Surg Neurol. 1990;34:345–351. doi: 10.1016/0090-3019(90)90013-f. [DOI] [PubMed] [Google Scholar]
  • 18.Mastronardi L, Ferrante L, Scarpinati M, Gagliardi FM, Celli P, Fortuna A. Intradural extramedullary cavernous angioma: case report. Neurosurgery. 1991;29:924–926. doi: 10.1097/00006123-199112000-00023. [DOI] [PubMed] [Google Scholar]
  • 19.Morello A, Tumbiolo A, Pinto G, Lo Duca B. Cavernous angioma of the spinal dura. J Neurosurg Sci. 1991;35:31–35. [PubMed] [Google Scholar]
  • 20.Ogilvy CS, Louis DN, Ojemann RG. Intramedullary cavernous angiomas of the spinal cord: clinical presentation, pathological features, and surgical treatment. Neurosurgery. 1992;31:219–230. doi: 10.1227/00006123-199208000-00007. [DOI] [PubMed] [Google Scholar]
  • 21.Padovani R, Poppi M, Pozzati E, Tognetti F, Querzola C. Spinal epidural hemangiomas. Spine. 1981;6:336–340. doi: 10.1097/00007632-198107000-00002. [DOI] [PubMed] [Google Scholar]
  • 22.Padovani R, Tognetti F, Proietti D, Pozzati E, Servadei F. Extrathecal cavernous hemangioma. Surg Neurol. 1982;18:463–465. doi: 10.1016/0090-3019(82)90191-4. [DOI] [PubMed] [Google Scholar]
  • 23.Pagni CA, Canavero S, Forni M. Report of a cavernoma of the cauda equina and review of the literature. Surg Neurol. 1990;33:124–131. doi: 10.1016/0090-3019(90)90021-g. [DOI] [PubMed] [Google Scholar]
  • 24.Ramos F, Jr, Toffol B, Aesch B, Jan M. Hydrocephalus and cavernoma of the cauda equina. Neurosurgery. 1990;27:139–142. doi: 10.1097/00006123-199007000-00023. [DOI] [PubMed] [Google Scholar]
  • 25.Rigamonti D, Drayer BP, Johnson PC, Hadley MN, Zabramsky J, Spetzler RF. The MRI appearance of cavernous malformations (angiomas) J Neurosurg. 1987;67:518–524. doi: 10.3171/jns.1987.67.4.0518. [DOI] [PubMed] [Google Scholar]
  • 26.Ross JS, Masaryk TJ, Modic MT, Carter JR, Mapstone T, Dengel FH. Vertebral hemangiomas: MR imaging. Radiology. 1987;165:165–169. doi: 10.1148/radiology.165.1.3628764. [DOI] [PubMed] [Google Scholar]
  • 27.Russel DS, Rubinstein LJ. Pathology of tumors of the nervous system. 5th edn. Baltimore: Williams and Wilkins; 1989. pp. 730–736. [Google Scholar]
  • 28.Sharma R, Rout D, Radhakrishnan VV. Intradural spinal cavernomas. Br J Neurosurg. 1992;6:351–356. doi: 10.3109/02688699209023794. [DOI] [PubMed] [Google Scholar]
  • 29.Singh RVP, Suys S, Campbell DA, Broome JC. Spinal extradural cavernous angioma. Br J Neurosurg. 1993;7:79–82. doi: 10.3109/02688699308995060. [DOI] [PubMed] [Google Scholar]
  • 30.Stechison MT, Panagis SG, Reinhart SS. Somatosensory evoked potential monitoring during spinal surgery. Acta Neurochir. 1995;135:56–61. doi: 10.1007/BF02307415. [DOI] [PubMed] [Google Scholar]
  • 31.Tekkok IH, Acikgoz B, Saglam S, Onol B. Vertebral hemangioma symptomatic during pregnancy. Report of a case and review of the literature. Neurosurgery. 1993;32:302–306. doi: 10.1227/00006123-199302000-00022. [DOI] [PubMed] [Google Scholar]

Articles from European Spine Journal are provided here courtesy of Springer-Verlag

RESOURCES