Recently, the Department of Neurosurgery of the Second Affiliated Hospital of Anhui Medical University performed microsurgery for a patient with intramedullary cavernous cervical spinal cord Cervical intramedullary cavernous hemangioma was resected in an elderly male patient with hemangioma, which relieved the risk of rebleeding of the cavernous hemangioma and relieved the patient from the risk of paralysis.
Picture/ Zhao Bing performed microsurgery for the patient. In the case of incentives, symptoms such as pain in the back of the neck and weakness of the lower limbs appeared.
The MRI examination of the cervical spine showed that the patient had “intraspinal space-occupying lesions (C5)”. After further examination after hospitalization, the doctor confirmed that the patient was suffering from cervical spinal cord intramedullary. Cavernous hemangioma.
According to Prof. Zhao Bing, director of the department, intramedullary cavernous hemangioma of the spinal cord is not a true tumor, but a spinal vascular malformation, usually due to congenital development of spinal blood vessels Exception. The disease is very rare and has a very low incidence. It has the advantages of high diagnostic specificity and good surgical treatment effect. However, the surgery is risky and difficult, and the possibility of paralysis after bleeding is high. , the site of disease and the severity of the disease to choose the appropriate treatment time, in order to strive for the best treatment effect.
Zhao Bing pointed out that the patient’s onset was slow-onset, and obvious symptoms had already appeared. The possibility of re-bleeding was high. In severe cases, it could cause paralysis and even life-threatening. Surgical resection should be performed as soon as possible after diagnosis. Under the guidance of neurophysiological monitoring, microsurgery is the most effective way to remove intramedullary cavernous hemangioma of the spinal cord. The patient meets the indications for surgery and has no absolute contraindications to surgery. After comprehensive communication with the patient and his family, the neurosurgery It was decided to perform cervical intramedullary cavernous hemangioma resection for him.
After full preoperative preparation, Zhao Bing and colleagues in the department performed microsurgery for the patient under the guidance of neurophysiological monitoring, removing all the lesions and removing the tumor. The old blood clot was removed, and the total bleeding was less than 50 ml. Finally, the cervical intramedullary cavernous hemangioma was successfully removed. The process was very smooth, and the patient recovered well after the operation.
Zhao Bing introduced that the main symptoms of intramedullary cavernous hemangioma of the spinal cord are sensory and motor dysfunction, pain, muscle atrophy and sphincter dysfunction, etc., and those who have symptoms will rebleed The possibility is high, and severe cases can cause paralysis or even life-threatening. Therefore, for patients with a clear diagnosis, timely microsurgery is the safest and most effective treatment at present.
spinal intramedullary cavernous hemangioma
●< /span>Intramedullary cavernous hemangioma of the spinal cord is an occult spinal vascular malformation, which is generally considered to be a congenital developmental abnormality of spinal vessels. It is more common in young adults, more common in women, and the lesions are mostly located in the neck and thoracic segments. In the natural course of the disease, it can cause severe spinal cord damage due to hemorrhage and enlargement of the tumor, which compresses and destroys the spinal cord or nerve root, which can lead to paralysis and even life-threatening.
●The first symptom of intramedullary cavernous hemangioma of the spinal cord is mostly local pain, followed by paresthesias such as limb numbness and chest girdle feeling. Afterwards, symptoms such as limb weakness and dyskinesia occurred. The onset mode is basically divided into three types, namely acute onset type, recurrent type, and slow exacerbation type. However, there are also a small number of asymptomatic patients, which can only be found when they undergo MRI examination of the spinal cord.
●The rebleeding rate of asymptomatic intramedullary cavernous hemangioma is 1.4%-4.5%, while the rebleeding rate of symptomatic spinal intramedullary cavernous hemangioma is high Up to 66%, repeated bleeding can easily lead to neurological deterioration. Therefore, for symptomatic spinal cord intramedullary cavernous hemangioma, microsurgical radical resection of the lesion is the most effective treatment of choice. The preoperative neurological function, the relationship between the tumor and the spinal cord, the surgical technique and the degree of resection are important factors affecting the prognosis.
●For symptomatic intramedullary cavernous hemangioma, surgical resection should be performed as soon as possible, especially for recurrent cases, in order to prevent recurrence of bleeding and delay the operation timing and affect the curative effect. If the spinal cord is in the acute stage of spinal cord hemorrhage, the spinal cord is severely swollen and the gliosis zone around the lesion is not formed. At this time, the operation is likely to damage the spinal cord, and the lesion is likely to remain. Dehydration hormone treatment should be performed first, and then surgical treatment should be performed after 3 months.
Source: The Second Affiliated Hospital of Anhui Medical University