Thoracic Intramedullary Cavernous Malformation With Posttraumatic Hematomyelia: Case Report and Literature Review

Armstrong, Melissa J.; Hacein-Bey, Lotfi; Schneck, Michael J.; Nockels, Russ P.; Biller, José

doi:10.1016/j.jstrokecerebrovasdis.2006.01.003

« Previous Next »Journal of Stroke & Cerebrovascular Diseases
Volume 15, Issue 2 , Pages 74-78, March 2006

Thoracic Intramedullary Cavernous Malformation With Posttraumatic Hematomyelia: Case Report and Literature Review

Melissa J. Armstrong, MD
- Department of Neurology, Loyola University Medical Center, Stritch School of Medicine, Maywood, Illinois, USA
- Address correspondence to Melissa J. Armstrong, MD, Department of Neurology, Loyola University Medical Center, 2160 S First Ave, Maywood, IL 60153
Lotfi Hacein-Bey, MD
- Department of Neurology, Loyola University Medical Center, Stritch School of Medicine, Maywood, Illinois, USA
- Department of Radiology, Loyola University Medical Center, Stritch School of Medicine, Maywood, Illinois, USA
- Department of Neurological Surgery, Loyola University Medical Center, Stritch School of Medicine, Maywood, Illinois
Michael J. Schneck, MD
- Department of Neurology, Loyola University Medical Center, Stritch School of Medicine, Maywood, Illinois, USA
- Department of Neurological Surgery, Loyola University Medical Center, Stritch School of Medicine, Maywood, Illinois
Russ P. Nockels, MD
- Department of Neurological Surgery, Loyola University Medical Center, Stritch School of Medicine, Maywood, Illinois
José Biller, MD
- Department of Neurology, Loyola University Medical Center, Stritch School of Medicine, Maywood, Illinois, USA
- Department of Neurological Surgery, Loyola University Medical Center, Stritch School of Medicine, Maywood, Illinois

Received 27 December 2005; received in revised form 4 January 2006; accepted 10 January 2006.

Although intramedullary spinal cord cavernous malformations are now well described, there have been, to our knowledge, no prior reports focusing on presentation after trauma. We report a patient with a thoracic intramedullary cavernous malformation presenting with hematomyelia and acute neurologic deterioration after spinal chiropractic manipulation. A review of previously published case reports then identifies additional cases of deterioration after spinal cord trauma or exertion. Traumatic injury and exertion may be uncommon but real causes of hematomyelia in intramedullary cavernous malformations of the spinal cord. The frequency of such presentations is estimated to be 1.37% to 4.79%.

Key Words: Cavernous malformation , cavernous angioma , cavernous hemangioma , spinal cord , intramedullary , trauma , chiropractic , hematomyelia , hemorrhage