ANGIOMA CAVERNOSO DEL CONO MEDULLAR: REPORTE DE CASO
DOI:
https://doi.org/10.51437/nj.v25i3.86Palabras clave:
Hemangioma, Hemangioma Cavernoso, Hemanigioma Cavernoso del Sistema Nervioso CentralResumen
Paciente femenina de 60 años, sin antecedentes de importancia, quien debuta con disestesias en miembro inferior derecho, pérdida subjetiva de la fuerza e inestabilidad de la marcha. Al examen físico sin alteraciones motoras o sensitivas, con dolor a la palpación de la musculatura paralumbar así como para la extensión lumbar. Se consideró como diagnóstico dolor axial de tipo gravitativo, se realizaron 3 bloqueos facetarios con respuesta fluctuante y parcial. En la Resonancia se encontró una imagen de predominio hipointenso en la secuencia de T1, heterogénea y de predominio hiperintenso en T2, con halo hipointenso heterogénea, de localización intra-axial a nivel del cono medular compatible con cavernoma, se llevó el caso a junta médica donde se decidió realizar manejo conservador (Imipramina, Acetaminofen/Codeina) logrando control parcial del dolor neuropático y axial.
Citas
Anson JA, Spetzler RF.(1993) Surgical resection of intramedullary spinal cord cavernous malformations. J Neurosurg 78:446–451. DOI: 10.3171/jns.1993.78.3.0446
Badhiwala JH, Farrokhyar F, Alhazzani W, Yarascavitch B, Aref M, Algird A, et al.. (2014) Surgical outcomes and natural history of intramedullary spinal cord cavernous malformations: a single-center series and meta-analysis of individual patient data: Clinic article. J Neurosurg Spine 21:662–676. DOI: 10.3171/2014.6.SPINE13949
Bian LG, Bertalanffy H, Sun QF, Shen JK. (2009). Intramedullary cavernous malformations: clinical features and surgical technique via hemilaminectomy. Clin Neurol Neurosurg 111:511–517.DOI:10.1016/j.clineuro.2009.02.003.
Cooper PR, Epstein F. (1985). Radical resection of intramedullary spinal cord tumors in adults. Recent experience in 29 patients. J Neurosurg 63:492–499.DOI: 10.3171/jns.1985.63.4.0492
Edward R. Smith, MD*, R. Michael Scott, MD.2010.Cavernous Malformations. Neurosurg Clin N Am 21 (2010) 483–490. DOI:10.1016/j.nec.2010.03.003.
Gross BA1,Du R, Popp AJ, DaY AL.2010.Intramedullary spinal cord cavernous malformations. Neurosurg Focus 29 (3):E14. DOI: 10.3171/2010.6.FOCUS10144
González Andrés A, Castañeda Marcelo D,Pimienta Hebert R. (2018). Enfoque diagnóstico de la lumbalgia - Parte 1: Revisión sistemática de la literatura. Neurocienc J. 2018; 25(2). Available at: http://132.148.153.5/apps/ojs311/index.php/neurocienciasjournal/article/view/46
Hegde A, Mohan S, Tan KK et al. (2012a). Spinal cavernous malformations: magnetic resonance imaging and associated findings. Singapore Med J 53: 582–586. Available at: https://www.ncbi.nlm.nih.gov/pubmed/23023898
Hernández, D., Moraleda, S., Royo, A. et al. (1999) Cavernous angioma of the conus medullaris as a cause of paraplegia. Spinal Cord 37, 65–67 DOI:10.1038/sj.sc.3100716
Khalatbari, M.R., Hamidi, M. & Moharamzad, (2011). pediatric intramedullary cavernous malformation of the conus medullaris: case report and review of the literature.Childs Nerv Syst 27: 507. Available at: https://doi.org/10.1007/s00381-010-1350-4
Kivelev J, Niemelä M, Hernesniemi J. (2010). Outcome after microsurgery in 14 patients with spinal cavernomas and review of the literature. J Neurosurg Spine 13:524–534. DOI: 10.3171/2010.4.SPINE09986
Krings, T., Mull, M., Gilsbach, J.M. et al. (2005) Espinal Vascular Malformations. Eur Radiol (2005) 15: 267. Available at: https://doi.org/10.1007/s00330-004-2510-2.
Luis Arquez H MD,Juan Camilo Covaleda Rodríguez MD.( 2018).Economía en la era tecnológica de la neurocirugía.Neurocienc J. 2018; 25(1). Available at:http://132.148.153.5/apps/ojs311/index.php/neurocienciasjournal/article/view/33. 14. Maraire JN, Abdulrauf SI, Berger S et al. (1999). De novo development of a cavernous malformation of the spinal cord following spinal axis radiation. Case report. J Neurosurg 90: 234–238. DOI:10.3171/spi.1999.90.2.0234
Mastronardi, L., Frondizi, D., Guiducci, A. et al. (1999)Conus medullaris hematomyelia associated with an intradural-extramedullary cavernous angioma. Spinal Cord 37, 68–70 DOI:10.1038/sj.sc.3100768
Matthias Reitz MD , Till Burkhardt MD , Eik Vettorazzi MSc , Frank Raimund MD , Erik Fritzsche MD , Nils Ole Schmidt MD , Jan Regelsberger MD , Manfred Westphal MD and Sven Oliver Eicker MD. (2015). Intramedullary spinal cavernoma: clinical presentation, microsurgical approach, and long-term outcome in a cohort of 48 patients. Neurosurg Focus 39 (2):E19,. Available at:https://doi.org/10.3171/2015.5.FOCUS15153
Mitha AP, Turner JD, Abla AA, Vishteh AG, Spetzler RF. (2011)Outcomes following resection of intramedullary spinal cord cavernous malformations: a 25-year experience. J Neurosurg Spine 14:605–611. Available at: https://www.ncbi.nlm.nih.gov/pubmed/21388288
Mujagic S, Becirovic-Ibrisevic J (2012). The developmental venous anomaly associated with the cavernous malformation. Acta Med Acad 41: 219–220.DOI: 10.5644/ama2006-124.55
Obermann, Mark & Gizewski, Elke & Felsberg, J & Maschke, Matthias. (2006). Cavernous malformation with hemorrhage of the conus medullaris and progressive sensory loss. Clinical neuropathology. 25. 95-7. Available at: https://www.ncbi.nlm.nih.gov/pubmed/16550743
R.F. Spetzler, K. Moon, and R.O. Almefty, Editors. 2017. Arteriovenous and Cavernous Malformations. Handbook of Clinical Neurology. Vol. 143 (3rd series).P 2-234
Srikant Balasubramaniam, MD. Amit Mahore, MD.2013. Cavernoma of conus medullaris, cavernous angioma of the cord, intramedullary cavernoma, transverse myelitis Singapore Med J; 54(2): e24–e27. DOI: 10.11622/smedj.2013034
Vishteh AG, Sankhla S, Anson JA, Zabramski JM, Spetzler RF.(1997). Surgical resection of intramedullary spinal cord cavernous malformations: delayed complications, long-term outcomes, and association with cryptic venous malformations. Neurosurgery 41:1094–1101. DOI: 10.1097/00006123-199711000-00013
Weinzierl MR, Krings T, Corinth MC, Reinges MH, Gilsbach JM (2004) MRI and intraoperative findings in cavernous haemangiomas of the spinal cord. Neuroradiology 46:65–71. DOI: 10.1007/s00234-003-1072-3
Badhiwala JH, Farrokhyar F, Alhazzani W, Yarascavitch B, Aref M, Algird A, et al.. (2014) Surgical outcomes and natural history of intramedullary spinal cord cavernous malformations: a single-center series and meta-analysis of individual patient data: Clinic article. J Neurosurg Spine 21:662–676. DOI: 10.3171/2014.6.SPINE13949
Bian LG, Bertalanffy H, Sun QF, Shen JK. (2009). Intramedullary cavernous malformations: clinical features and surgical technique via hemilaminectomy. Clin Neurol Neurosurg 111:511–517.DOI:10.1016/j.clineuro.2009.02.003.
Cooper PR, Epstein F. (1985). Radical resection of intramedullary spinal cord tumors in adults. Recent experience in 29 patients. J Neurosurg 63:492–499.DOI: 10.3171/jns.1985.63.4.0492
Edward R. Smith, MD*, R. Michael Scott, MD.2010.Cavernous Malformations. Neurosurg Clin N Am 21 (2010) 483–490. DOI:10.1016/j.nec.2010.03.003.
Gross BA1,Du R, Popp AJ, DaY AL.2010.Intramedullary spinal cord cavernous malformations. Neurosurg Focus 29 (3):E14. DOI: 10.3171/2010.6.FOCUS10144
González Andrés A, Castañeda Marcelo D,Pimienta Hebert R. (2018). Enfoque diagnóstico de la lumbalgia - Parte 1: Revisión sistemática de la literatura. Neurocienc J. 2018; 25(2). Available at: http://132.148.153.5/apps/ojs311/index.php/neurocienciasjournal/article/view/46
Hegde A, Mohan S, Tan KK et al. (2012a). Spinal cavernous malformations: magnetic resonance imaging and associated findings. Singapore Med J 53: 582–586. Available at: https://www.ncbi.nlm.nih.gov/pubmed/23023898
Hernández, D., Moraleda, S., Royo, A. et al. (1999) Cavernous angioma of the conus medullaris as a cause of paraplegia. Spinal Cord 37, 65–67 DOI:10.1038/sj.sc.3100716
Khalatbari, M.R., Hamidi, M. & Moharamzad, (2011). pediatric intramedullary cavernous malformation of the conus medullaris: case report and review of the literature.Childs Nerv Syst 27: 507. Available at: https://doi.org/10.1007/s00381-010-1350-4
Kivelev J, Niemelä M, Hernesniemi J. (2010). Outcome after microsurgery in 14 patients with spinal cavernomas and review of the literature. J Neurosurg Spine 13:524–534. DOI: 10.3171/2010.4.SPINE09986
Krings, T., Mull, M., Gilsbach, J.M. et al. (2005) Espinal Vascular Malformations. Eur Radiol (2005) 15: 267. Available at: https://doi.org/10.1007/s00330-004-2510-2.
Luis Arquez H MD,Juan Camilo Covaleda Rodríguez MD.( 2018).Economía en la era tecnológica de la neurocirugía.Neurocienc J. 2018; 25(1). Available at:http://132.148.153.5/apps/ojs311/index.php/neurocienciasjournal/article/view/33. 14. Maraire JN, Abdulrauf SI, Berger S et al. (1999). De novo development of a cavernous malformation of the spinal cord following spinal axis radiation. Case report. J Neurosurg 90: 234–238. DOI:10.3171/spi.1999.90.2.0234
Mastronardi, L., Frondizi, D., Guiducci, A. et al. (1999)Conus medullaris hematomyelia associated with an intradural-extramedullary cavernous angioma. Spinal Cord 37, 68–70 DOI:10.1038/sj.sc.3100768
Matthias Reitz MD , Till Burkhardt MD , Eik Vettorazzi MSc , Frank Raimund MD , Erik Fritzsche MD , Nils Ole Schmidt MD , Jan Regelsberger MD , Manfred Westphal MD and Sven Oliver Eicker MD. (2015). Intramedullary spinal cavernoma: clinical presentation, microsurgical approach, and long-term outcome in a cohort of 48 patients. Neurosurg Focus 39 (2):E19,. Available at:https://doi.org/10.3171/2015.5.FOCUS15153
Mitha AP, Turner JD, Abla AA, Vishteh AG, Spetzler RF. (2011)Outcomes following resection of intramedullary spinal cord cavernous malformations: a 25-year experience. J Neurosurg Spine 14:605–611. Available at: https://www.ncbi.nlm.nih.gov/pubmed/21388288
Mujagic S, Becirovic-Ibrisevic J (2012). The developmental venous anomaly associated with the cavernous malformation. Acta Med Acad 41: 219–220.DOI: 10.5644/ama2006-124.55
Obermann, Mark & Gizewski, Elke & Felsberg, J & Maschke, Matthias. (2006). Cavernous malformation with hemorrhage of the conus medullaris and progressive sensory loss. Clinical neuropathology. 25. 95-7. Available at: https://www.ncbi.nlm.nih.gov/pubmed/16550743
R.F. Spetzler, K. Moon, and R.O. Almefty, Editors. 2017. Arteriovenous and Cavernous Malformations. Handbook of Clinical Neurology. Vol. 143 (3rd series).P 2-234
Srikant Balasubramaniam, MD. Amit Mahore, MD.2013. Cavernoma of conus medullaris, cavernous angioma of the cord, intramedullary cavernoma, transverse myelitis Singapore Med J; 54(2): e24–e27. DOI: 10.11622/smedj.2013034
Vishteh AG, Sankhla S, Anson JA, Zabramski JM, Spetzler RF.(1997). Surgical resection of intramedullary spinal cord cavernous malformations: delayed complications, long-term outcomes, and association with cryptic venous malformations. Neurosurgery 41:1094–1101. DOI: 10.1097/00006123-199711000-00013
Weinzierl MR, Krings T, Corinth MC, Reinges MH, Gilsbach JM (2004) MRI and intraoperative findings in cavernous haemangiomas of the spinal cord. Neuroradiology 46:65–71. DOI: 10.1007/s00234-003-1072-3
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2020-03-27
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Ramírez, E., González, A., & Castañeda, M. (2020). ANGIOMA CAVERNOSO DEL CONO MEDULLAR: REPORTE DE CASO. Neurociencias Journal, 25(3), 43–49. https://doi.org/10.51437/nj.v25i3.86
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