Intramedullary spinal cord cavernous malformations in the pediatric population

Author:

Fiani Brian1,Reardon Taylor2,Jenkins Ryne3,Covarrubias Claudia4,Sekhon Manraj5,Soula Marisol6,Kortz Michael7

Affiliation:

1. Department of Neurosurgery, Desert Regional Medical Center, Palm Springs, CA,

2. Kentucky College of Osteopathic Medicine, University of Pikeville, Pikeville, KY,

3. College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA, United States,

4. School of Medicine, Universidad Anáhuac Querétaro, Cto. Universidades, Santiago, de Querétaro, Mexico,

5. William Beaumont School of Medicine, Oakland University, Rochester, Michigan,

6. Grossman School of Medicine, New York University, New York,

7. Department of Neurosurgery, University of Colorado, Aurora, Colorado, United States.

Abstract

Background: Intramedullary spinal cavernous malformations (ISCM) account for just 1% of all intramedullary pediatric spinal cord lesions. Pathologically, they are well-circumscribed vascular malformations that typically appear dark blue or reddish-brown, often coming to the spinal cord surface. With regard to the histopathology findings, ISCMs are comprised sinusoidal vascular spaces lined by a single layer of endothelial cells within a loose connective tissue stroma. As these lesions are often misdiagnosed in the pediatric population, appropriate treatment may be unduly delayed. Methods: The authors performed an extensive review of the published literature (PubMed) focusing on ISCM in the pediatric age group. Results: The search yielded 17 articles exclusively pertaining to ISCM affecting the pediatric population. Conclusion: Here, we reviewed the clinical, radiographic, surgical, and outcome data for the treatment of ISCM in the pediatric age groups. Notably, over 50% of pediatric patients with ISCM experienced an improvement in their neurological status after a mean postoperative follow-up duration of 4 years. Future meta-analyses are needed to highlight the potential presence of ISCM and, thereby, decrease the rate of misdiagnosis of these lesions in the pediatric population presenting with recurrent intramedullary spinal cord hemorrhages.

Publisher

Scientific Scholar

Subject

Clinical Neurology,Surgery

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