DOI: https://doi.org/10.22141/2224-0713.5.91.2017.110860

Disorders of spinal blood circulation

O.M. Hevyak, A.P. Kuzminskyy

Abstract


Spinal strokes are rare. The most common causes of the haemorrhage are spinal cord trauma, vasculitis with signs of haemorrhagic diathesis, spinal vascular congenital anomalies (malformations) and haemangioma. By localization, haemorrhagic strokes are divided into three groups: haematomyelia, spinal subarachnoid haemorrhage, epidural hematoma. Most cavernous malformations are localized at the cervical level, fewer — at thoracic and lumbar levels of the spinal cord. The clinical case of diagnosis and treatment of spinal hemorrhage in cervical thickening of dorsal columns (C8) and intramedullary cavernous hemangioma (angioreticuloma) right at the C6 vertebra of the patient in acute and early recovery period is described. Deep neurological symptoms in the postoperative period caused myelomalacia area and cavernous malformation lasting growth. Our clinical case is interesting because the disorder of spinal blood circulation (bleeding in cervical thickening of dorsal columns at C8 segment of the spinal cord) caused by cavernous haemangioma (angioreticuloma). Neurological symptoms escalated for four days. Magnetic resonance imaging (MRI) is the main diagnostic instrument for intramedullary spinal haemorrhage and cavernous haemangioma of the spine. Neck pain, aseptic inflammatory reaction (37.5–38 °C) regressed on day 10 (16.10.16) indicating a favourable course of spinal haemorrhage. Repeated MRI of the cervical spine (09.11.16) shows that signs of bleeding in the spinal cord dorsal columns (C8) regressed. Thinning of the myelomalacia area at C6-C7 and haemosiderosis of the central channel walls are observed. Cavernous haemangioma intramedullary localization in the right half (laterally) of cervical thickening (C7), oedema, and complete spinal cord lesion syndrome required surgery. Tumour encapsulated at the level of C6 vertebra with low extramedullary invasion was completely removed without any complications. Marked neurological deficit, as paresis, segmental and conduction type of sensory disorders and urinary retention, were still observed at discharge from the hospital (31.12.16). Patient moves using wheelchair, needs assistance. Rehabilitation requires prolonged and continued treatment in specialized centres.

Keywords


spinal hemorrhage; cavernous hemangioma (angioreticuloma); treatment

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