Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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April 13, 2009
Spinal Cord Cavernous Malformation
- Vascular lesion with lobulated, thin sinusoidal vascular channels and no interspersed normal neural tissue.
- Best diagnostic clue: blood locules with fluid levels surrounded by T2 hypointense rim; calcification is rare in spinal cord cavernomas.
- Spinal cord is an uncommon site for cavernomas (3-5% of all cavernous malformations). If a lesion is seen in cord, brain needs to be imaged to look for additional lesions.
- Distribution in spinal cord: thoracic (50%), cervical (40%), conus (10%).
- Subarachnoid hemorrhage is very rare; bleeding rate is 1-5% per lesion per year. Clinical presentation: young adult (3rd-6th decades), sudden paraplegia, 2:1 female.
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