Clinically symptomatic cervical intramedullary intradural cavernoma with isolated intramedullary hemorrhage and Brown-Sequard Syndrome

Abstract

Abstract Introduction Spinal cavernomas (SC) are uncommon lesions with an overall incidence rate of 0.04–0.05% in the population. This vascular pathology accounts for 3–5% of all CNS lesions and accounts for approximately 15% of all spinal vascular malformations. SC is diagnosed based on the presence of neurological deficits and complaints from the patient. Clinical presentation depends on location. Early intervention could yield a better outcome. Case Report A female, 15 years old, came with complaints of pain in the back of the neck for 4 months before admission, the patient also felt weakness in the right limb for 2 months before admission. Patient wuth Brown Sequard syndrome involving the C1-C2 level, with a right hemiparesis and bowel and bladder incontinence. The patient had surgery because she was symptomatic. Discussion There are few indications for surgery in SC, but in general, surgery can be considered in patients with symptomatic lesion. One of the most commonly approaches is unilateral laminectomy, and this approach yields better outcomes when compared to laminoplasty or total laminectomy. Conclusion In our case, a 15-year-old female with an intramedullary mass in the cervical with clinical symptoms resembling Brown Sequard syndrome.The surgical results of treating this lesion were positive. This report highlights not only a unique case, but also the fact that in patients with progressive neurological decline, surgical intervention for spinal cavernomas can be performed safely and offers decompression, diagnosis, and prevention against further hemorrhage.