[马尾海绵状血管瘤:病例报告]。

Soledad Heredia-Gutiérrez, María Eugenia Carbarín-Carbarín, Antonio Heredia-Gutiérrez
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引用次数: 0

摘要

背景:海绵状血管瘤是一种血管畸形,由成群的扩张窦道组成,窦道内有单层内皮。海绵状血管瘤仅占硬膜内病变的 3%,其中 5-12% 为脊髓病变,马尾血管瘤则很少见:患者 57 岁,男性,无放疗史,6 个月来出现腰背痛、背肌和脊柱旁肌肉挛缩,在另一家医院进行了评估,诊断为腰椎间盘突出症,接受了两个月的镇痛剂和物理治疗,但治疗失败,症状加重,臀部和肛周出现疼痛,双腿力量减弱,以左腿为主,膀胱括约肌功能障碍。对腰骶部脊柱进行了简单的磁共振成像检查,发现在 L1-2 水平处有椎管内和硬膜内病变。他被诊断为马尾综合征,并接受了手术治疗。手术后,患者的临床症状有所改善和缓解。术后一个月在门诊复查时,患者已能独立行走,目前无任何症状。病理解剖结果显示为海绵状血管瘤:马尾海绵状血管瘤非常罕见,如果伴有马尾综合征,建议首选早期手术治疗,以避免永久性神经损伤。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Cavernous hemangioma of the cauda equina: A case report].

Background: Cavernous hemangiomas are vascular malformations formed by groups of dilated sinusoids, organized in channels with a single layer of endothelium. Cavernous hemangiomas represent only 3% of all intradural lesions, and of these 5-12 % correspond to spinal cord lesions and those of the cauda equina are rare.

Clinic case: A 57 years-old male patient is presented , without history of radiotherapy, who showed low back pain and contracture of the dorsal and paraspinal muscle during 6 months, evaluated in another hospital and diagnosed with a lumbar disc herniation, he was managed with analgesics and physiotherapy for two months, however the theraphy failed, the symptoms worsened and dysesthesias appeared in the gluteal and perianal region, with reduction of strength in both legs with predominance in the left leg, as well bladder sphincter dysfunction . A simple magnetic resonance imaging of the lumbosacral spine was performed, revealing an intraspinal and intradural lesion at the L1-2 level. He was diagnosed with cauda equina syndrome and surgery was carried out. After surgery the patient presented clinical improvement and resolution of symptoms. During follow-up in the outpatient clinic, one month after surgery, the patient was able to walk independently and is currently asymptomatic. The pathological anatomy result reported a cavernous hemangioma.

Conclusions: Cavernous hemangiomas of the cauda equina are rare, and when they are associated with a cauda equina syndrome, early surgery is recommended like the first option treatment to avoid permanent neurological injury.

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