The clinical features and surgical outcomes of patients with intramedullary spinal cord cavernous malformations

Abstract

CMs are not uncommon, but most of them are found in intracranial location. Intramedullary CMs are rare, accounting for only 3–5% of the total central nervous system lesions identified. The natural history of intramedullary CMs and their clinical features including the risk of hemorrhages from a large series still remains unclear and need to be elucidated.Between March 2004 and March 2010, a total of 21 patients with intramedullary spinal cord CMs were surgically treated in a single institution. Data from 21 patients were analyzed retrospectively.There were thirteen females and eight males who ranged in age from 10 to 70 years (mean age 39.3 years). All patients harbored single symptomatic CM of the nervous system, and multiple lesions were not found. The annual retrospective hemorrhage rate was 2.2% per patient/year. All except one CM were completely resected and the average follow-up period was 22.1 months (1–73 months). Ten of the 21 patients experienced an improvement of the neurological state, nine patients remained unchanged, and two patients worsened.Symptomatic intramedullary CMs should be surgically removed to avoid further neurological deterioration. The prognosis was related to the preoperative neurologic state and the type of symptom presentation.