Document Detail


Outcome after microsurgery in 14 patients with spinal cavernomas and review of the literature.
MedLine Citation:
PMID:  20887151     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: Spinal cavernomas are rare, but can cause significant neurological deficits due to mass effect and extralesional hemorrhage. The authors present their results of microsurgical treatment of 14 consecutive patients with spinal cavernoma, and review the literature. METHODS: Of the 376 patients with cavernomas of the CNS treated at Helsinki University Central Hospital (a catchment area close to 2 million inhabitants) between January 1980 and June 2009, 14 (4%) had a spinal cavernoma. The authors reexamined and analyzed the patient files and images retrospectively. Median patient age at presentation was 45 years (range 20–57 years). The female/male ratio was equal. Median duration of symptoms before admission to the department was 12 months (range 0.1–168 months). Patients suffered from sensorimotor paresis, radicular pain, or neurogenic micturition disorders in different combinations or separately. Hemorrhage had occurred in 7 patients (50%) before surgery. In 9 patients (64%) the cavernoma was intramedullary, in 4 (29%) extradural, and in 1 intradural extramedullary. On MR imaging, 6 patients (43%) had a cavernoma in the cervical region, 7 (50%) in the thoracic region, and 1 (7%) in the lumbar region. RESULTS: Postoperatively, patients were followed up for a median of 3 years (range 1–10 years). At follow-up, 13 patients (93%) experienced significant improvement in motor ability after surgery, and all patients were able to walk with or without aid. Ten of the 11 patients with pain syndrome (91%) showed significant pain relief without recurrence. Micturition disorder was noted in 6 patients (43%) at follow-up, but in 5 the condition had existed before surgery. No patient improved in bladder function after surgery, and 1 patient developed micturition dysfunction postoperatively. CONCLUSIONS: Microsurgical removal of spinal cavernomas alleviates sensorimotor deficits and pain caused by mass effect and hemorrhage. However, bladder dysfunction remains unchanged after surgery.
Authors:
Juri Kivelev; Mika Niemelä; Juha Hernesniemi
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of neurosurgery. Spine     Volume:  13     ISSN:  1547-5646     ISO Abbreviation:  J Neurosurg Spine     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-04     Completed Date:  2010-10-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101223545     Medline TA:  J Neurosurg Spine     Country:  United States    
Other Details:
Languages:  eng     Pagination:  524-34     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Helsinki University Central Hospital, Helsinki, Finland. juri.kivelev@hus.fi
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Female
Follow-Up Studies
Hemangioma, Cavernous / complications,  diagnosis,  physiopathology,  surgery*
Hemorrhage / etiology
Humans
Laminectomy
Magnetic Resonance Imaging
Male
Medulla Oblongata / blood supply
Microsurgery*
Middle Aged
Movement Disorders / etiology
Pain / physiopathology
Paresis / etiology,  physiopathology
Retrospective Studies
Sensation Disorders / etiology
Spinal Neoplasms / complications,  diagnosis,  physiopathology,  surgery*
Treatment Outcome
Urinary Bladder / physiopathology
Urination Disorders / etiology
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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