Outcome in 53 patients with spinal cord cavernomas

Surg Neurol. 2008 Aug;70(2):176-81; discussion 181. doi: 10.1016/j.surneu.2007.06.039. Epub 2008 Jan 22.

Abstract

Background: Prevalence of cerebral cavernomas in the general population is close to 0.5%. In contrast, SCCs are rare. The aim of this study was to determine the outcome of SCC in a large sample of patients.

Methods: Clinical and neuroradiologic findings were retrospectively collected in a multicentric study. Diagnosis was based on pathologic criteria or MR findings.

Results: Fifty-three patients were included (26 males, 27 females). Mean age at onset of symptoms was 40.2 years (11-80 years). Initial symptoms were progressive (32) or acute myelopathy (20). One case was asymptomatic. Triggering factors were found in 14 of the patients (26%). Clinical symptoms were related to spinal cord compression (27) and hemorrhage (22). Spinal cord cavernoma was thoracic in 41 cases and cervical in 12. Mean size of the lesions was 16.3 mm (3-54 mm). In the 40 surgical patients, long-term follow-up was available in 37 cases for a mean time of 7.3 years (0.4-50 years). During the follow-up period, 20 patients improved, 6 remained on their preoperative baseline, and 11 got worse. Surgical improvement was more often found in posterior rather than anterior location. Using McCormick classification, 22 patients were autonomous (grades 1-2), 12 handicapped (grade 3), and 3 bedridden (grade 4) at the end of the follow-up.

Conclusions: This study has defined clinical and MR patterns of spinal cavernomas. Surgery lastingly improved more than half of the patients.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Aged
  • Aged, 80 and over
  • Child
  • Decompression, Surgical
  • Early Diagnosis
  • Female
  • Hemangioma, Cavernous, Central Nervous System / diagnostic imaging
  • Hemangioma, Cavernous, Central Nervous System / pathology*
  • Hemangioma, Cavernous, Central Nervous System / surgery*
  • Hemorrhage / etiology
  • Hemorrhage / pathology
  • Hemorrhage / surgery
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neurosurgical Procedures
  • Prognosis
  • Radiography
  • Retrospective Studies
  • Spinal Canal / anatomy & histology
  • Spinal Canal / diagnostic imaging
  • Spinal Canal / surgery
  • Spinal Cord / diagnostic imaging
  • Spinal Cord / pathology*
  • Spinal Cord / surgery*
  • Spinal Cord Compression / etiology
  • Spinal Cord Compression / pathology
  • Spinal Cord Compression / surgery
  • Spinal Cord Neoplasms / diagnostic imaging
  • Spinal Cord Neoplasms / pathology*
  • Spinal Cord Neoplasms / surgery*
  • Treatment Outcome