Cavernous hemangioma of the cauda equina: A case report

Authors

  • Soledad Heredia-Gutiérrez <p>Fomento Econ&oacute;mico Mexicano, Cl&iacute;nica de Salud Ocupacional y Bienestar, Servicio de Medicina Laboral. Le&oacute;n, Guanajuato, M&eacute;xico.</p> http://orcid.org/0009-0005-1296-1786
  • María Eugenia Carbarín-Carbarín <p>Instituto Mexicano del Seguro Social, Hospital General de Zona No. 20, Servicio de Terapia Intensiva Pedi&aacute;trica. Puebla, Puebla, M&eacute;xico.</p> http://orcid.org/0000-0002-6864-5396
  • Antonio Heredia-Gutiérrez <p>Instituto Mexicano del Seguro Social, Hospital de Especialidades &ldquo;Manuel &Aacute;vila Camacho&rdquo;, Servicio de Neurocirug&iacute;a. Puebla, Puebla, M&eacute;xico.</p> http://orcid.org/0000-0003-0116-8676

DOI:

https://doi.org/10.5281/zenodo.11397229

Keywords:

Hemangioma, Cavernous, Spinal Nerves, Low Back Pain

Abstract

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.

Clinical 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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Author Biographies

  • Soledad Heredia-Gutiérrez, <p>Fomento Econ&oacute;mico Mexicano, Cl&iacute;nica de Salud Ocupacional y Bienestar, Servicio de Medicina Laboral. Le&oacute;n, Guanajuato, M&eacute;xico.</p>

    MEDICO ADSCRITO AL DEPARTAMENTO DE MEDICINA LABORAL, DE LA CLINICA DE SALUD OCUPACIONAL Y BIENESTAR

  • María Eugenia Carbarín-Carbarín, <p>Instituto Mexicano del Seguro Social, Hospital General de Zona No. 20, Servicio de Terapia Intensiva Pedi&aacute;trica. Puebla, Puebla, M&eacute;xico.</p>

    MÉDICO ADSCRITO AL DEPARTAMENTO DE TERAPIA INTENSIVA PEDIATRICA DEL HGZ.20, PUEBLA, PUEBLA, MÉXICO

  • Antonio Heredia-Gutiérrez, <p>Instituto Mexicano del Seguro Social, Hospital de Especialidades &ldquo;Manuel &Aacute;vila Camacho&rdquo;, Servicio de Neurocirug&iacute;a. Puebla, Puebla, M&eacute;xico.</p>

    MÉDICO ADSCRITO AL DEPARTAMENTO DE NEUROCIRUGIA, DE LA UMAE IMSS PUEBLA, PUEBLA.

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Published

2024-07-18

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Section

Clinical Cases