Cervical Nerve Root Cavernoma – Case Report and Literature Review

Spinal cavernous angiomas are uncommon vascular malformations in the spine accounting for 5%-12% of all spinal vascular lesions. When present in an intradural extra-medullary location, these usually present with radicular pain and neurological deficits due to mass effect (myelopathy). Herein, we pre...

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Main Authors: Sandeep Moolchandani, Gaurav Tyagi, Nishant S Yagnick, Sumit Sinha, Veer Singh Mehta
Format: Article
Language:English
Published: Shahid Beheshti University of Medical Sciences 2023-01-01
Series:International Clinical Neuroscience Journal
Subjects:
Online Access:https://journals.sbmu.ac.ir/neuroscience/article/view/39028/30670
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author Sandeep Moolchandani
Gaurav Tyagi
Nishant S Yagnick
Sumit Sinha
Veer Singh Mehta
author_facet Sandeep Moolchandani
Gaurav Tyagi
Nishant S Yagnick
Sumit Sinha
Veer Singh Mehta
author_sort Sandeep Moolchandani
collection DOAJ
description Spinal cavernous angiomas are uncommon vascular malformations in the spine accounting for 5%-12% of all spinal vascular lesions. When present in an intradural extra-medullary location, these usually present with radicular pain and neurological deficits due to mass effect (myelopathy). Herein, we present an atypical presentation of cavernous angioma in a 54-year-old man with tinnitus, headache and sensorineural hearing loss. We have also reviewed 51 cases of intradural extramedullary cavernous angiomas including our case with respect to demographic and clinical profile. A 54-year-old man presented with tinnitus in the left ear and occipital headache with neck pain and slight weakness of left-hand grip along with atrophy of thenar muscles. His pure tone audiometry (PTA) test reveled mild left sensorineural hearing loss. Magnetic resonance imaging (MRI) of cervical spine showed T2WI heterogeneously hyperintense left intradural extramedullary lesion at C7 vertebral body level. It was avidly enhancing with contrast. The patient underwent C7 laminectomy with a midline durotomy and complete excision of the lesion under neuromonitoring with sacrifice of the C8 sensory root. His symptoms improved following the surgery. The diagnosis of a cavernoma in an unusual location in the presence of cranial nerve dysfunction needs a high degree of diagnostic suspicion. Most of these cavernomas have a nerve root origin or attachment. The optimal treatment is microsurgical en bloc resection which leads to an effective resolution of both the symptoms.
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spelling doaj.art-2fe0cdad9c6c4c8babbe18ce3f6a10012023-10-15T09:43:41ZengShahid Beheshti University of Medical SciencesInternational Clinical Neuroscience Journal2383-18712383-20962023-01-01101e2e210.34172/icnj.2023.02icnj-12184Cervical Nerve Root Cavernoma – Case Report and Literature ReviewSandeep Moolchandani0Gaurav Tyagi1Nishant S Yagnick2Sumit Sinha3Veer Singh Mehta4Department of Neurosurgery, MGM Medical College, Indore, IndiaDepartment of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, IndiaDepartment of Neurosurgery, Manipal Hospitals, Gurgaon, IndiaDepartment of Neurosurgery, Paras Hospitals, Gurgaon, IndiaDepartment of Neurosurgery, Paras Hospitals, Gurgaon, IndiaSpinal cavernous angiomas are uncommon vascular malformations in the spine accounting for 5%-12% of all spinal vascular lesions. When present in an intradural extra-medullary location, these usually present with radicular pain and neurological deficits due to mass effect (myelopathy). Herein, we present an atypical presentation of cavernous angioma in a 54-year-old man with tinnitus, headache and sensorineural hearing loss. We have also reviewed 51 cases of intradural extramedullary cavernous angiomas including our case with respect to demographic and clinical profile. A 54-year-old man presented with tinnitus in the left ear and occipital headache with neck pain and slight weakness of left-hand grip along with atrophy of thenar muscles. His pure tone audiometry (PTA) test reveled mild left sensorineural hearing loss. Magnetic resonance imaging (MRI) of cervical spine showed T2WI heterogeneously hyperintense left intradural extramedullary lesion at C7 vertebral body level. It was avidly enhancing with contrast. The patient underwent C7 laminectomy with a midline durotomy and complete excision of the lesion under neuromonitoring with sacrifice of the C8 sensory root. His symptoms improved following the surgery. The diagnosis of a cavernoma in an unusual location in the presence of cranial nerve dysfunction needs a high degree of diagnostic suspicion. Most of these cavernomas have a nerve root origin or attachment. The optimal treatment is microsurgical en bloc resection which leads to an effective resolution of both the symptoms.https://journals.sbmu.ac.ir/neuroscience/article/view/39028/30670cavernous hemangiomascavernous angiomaspinal nerve root
spellingShingle Sandeep Moolchandani
Gaurav Tyagi
Nishant S Yagnick
Sumit Sinha
Veer Singh Mehta
Cervical Nerve Root Cavernoma – Case Report and Literature Review
International Clinical Neuroscience Journal
cavernous hemangiomas
cavernous angioma
spinal nerve root
title Cervical Nerve Root Cavernoma – Case Report and Literature Review
title_full Cervical Nerve Root Cavernoma – Case Report and Literature Review
title_fullStr Cervical Nerve Root Cavernoma – Case Report and Literature Review
title_full_unstemmed Cervical Nerve Root Cavernoma – Case Report and Literature Review
title_short Cervical Nerve Root Cavernoma – Case Report and Literature Review
title_sort cervical nerve root cavernoma case report and literature review
topic cavernous hemangiomas
cavernous angioma
spinal nerve root
url https://journals.sbmu.ac.ir/neuroscience/article/view/39028/30670
work_keys_str_mv AT sandeepmoolchandani cervicalnerverootcavernomacasereportandliteraturereview
AT gauravtyagi cervicalnerverootcavernomacasereportandliteraturereview
AT nishantsyagnick cervicalnerverootcavernomacasereportandliteraturereview
AT sumitsinha cervicalnerverootcavernomacasereportandliteraturereview
AT veersinghmehta cervicalnerverootcavernomacasereportandliteraturereview