CONCLUSIONS Symptomatic vertebral hemangiomas are rare but should be considered as a differential diagnosis. Postoperatively, spasticity improved, and the patient regained normal power.
Biopsy of permanent samples showed proliferation of blood vessels with dilated spaces and no malignant cells, consistent with hemangioma. The patient underwent decompression and fixation. A CT scan showed a diffuse body lesion at the 8th thoracic vertebra with coarse trabeculations, corduroy appearance, or jail-bar sign. Neurological examination revealed lower limb weakness with power 3/5, exaggerated deep tendon reflexes, bilateral sustained clonus, impaired sensation below the umbilicus, spasticity, and a positive Babinski sign. There was no history of bowel or bladder incontinence. It was associated with both lower limb weakness and decreased sensation. CASE REPORT An 18-year-old male presented to the emergency room with a one-month history of mild to moderate mid-thoracic back pain, radiating to both lower limbs. When hemangiomas occur in the thoracic vertebrae, they are more likely to be symptomatic due to the narrow vertebral canal dimensions that mandate more aggressive management prior to the onset of severe neurological sequelae. In fact, only 0.9-1.2% of all vertebral hemangiomas may be symptomatic. The coupling of preoperative transarterial embolization followed by vertebroplasty, with or without surgical decompression depending on the patients' presenting symptoms, is a relatively safe treatment and may offer longĪ Symptomatic Case of Thoracic Vertebral Hemangioma Causing Lower Limb Spastic Paresis.Īlfawareh, Mohammad Alotaibi, Tariq Labeeb, Abdallah Audat, ZiadīACKGROUND Despite being the most common tumor of the spine, vertebral hemangioma is rarely symptomatic in adults. A review of the relevant literature, however, discloses only few management algorithms for such lesions. Symptomatic hemangioma involving the vertebral column may pose a therapeutic challenge, often requiring the active involvement of several disciplines.
All patients had an overall uneventful postoperative course and reported symptomatic relief to varying degrees, at an average follow-up period of 35 months. Her clinical course during evaluation was complicated by an acute pulmonary embolic event that necessitated installation of an inferior vena cava filter. A 35-year-old woman presented during pregnancy. Four patients underwent preoperative transarterial embolization followed by laminectomy and vertebroplasty of the affected level and 2 patients were treated with vertebroplasty alone. One patient had muscle weakness, 3 revealed sensory impairment, and the remaining 2 were neurologically intact. Our patients presented with either simple or radicular back pain.
The lesions occupied the thoracic, lumbar, or multiple segments. Six patients were diagnosed with symptomatic vertebral hemangioma between 19. The clinical and radiographic data of 6 patients diagnosed with symptomatic vertebral hemangioma and treated at our medical center over a period of 10 years were reviewed and analyzed retrospectively. Several treatment modalities are available in the management of such symptomatic conversion. These usually dormant lesions may become symptomatic by causing pain, neurologic deficit, or both. Hemangioma is one of the commonest benign neoplasms affecting the vertebral column. To analyze our experience in the treatment of symptomatic vertebral hemangioma, review the relevant literature, and propose a management algorithm. Management of symptomatic vertebral hemangioma: follow-up of 6 patients.īlecher, Ronen Smorgick, Yossi Anekstein, Yoram Peer, Amir Mirovsky, Yigal