Hemorrhage of cavernous malformations during pregnancy and in the peripartum period: causal or coincidence? Case report and review of the literature

Neurosurg Focus. 2006 Jul 15;21(1):e12. doi: 10.3171/foc.2006.21.1.13.

Abstract

There is growing evidence to suggest that pregnancy may increase the risk of hemorrhage from cavernous malformations (CMs). In the present case, a 21-year-old primigravida was admitted to the authors' neurosurgical service after a cesarean section. Three weeks before admission she had experienced rapidly progressive bilateral lower-extremity paresthesias. Spinal magnetic resonance (MR) imaging revealed the presence of an intramedullary thoracic lesion. On T2-weighted MR images, heterogeneous signal intensity with a rim of decreased intensity was demonstrated in the spine. The mass was successfully resected, and 1 year later the patient's symptoms had resolved completely. This is the fourth reported case of a spinal intramedullary CM that became symptomatic during pregnancy. The pathogenesis and management of this entity are reviewed.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cesarean Section
  • Disease Progression
  • Early Diagnosis
  • Emergency Treatment / standards
  • Female
  • Hemangioma, Cavernous, Central Nervous System / complications*
  • Hemangioma, Cavernous, Central Nervous System / physiopathology*
  • Hemangioma, Cavernous, Central Nervous System / surgery
  • Hemorrhage / etiology
  • Hemorrhage / prevention & control
  • Hemorrhage / surgery
  • Humans
  • Magnetic Resonance Imaging
  • Neurosurgical Procedures / methods
  • Paresthesia / etiology
  • Paresthesia / physiopathology
  • Pregnancy
  • Pregnancy Complications, Neoplastic / diagnosis
  • Pregnancy Complications, Neoplastic / etiology*
  • Pregnancy Complications, Neoplastic / physiopathology
  • Spinal Cord / blood supply
  • Spinal Cord / pathology*
  • Spinal Cord / physiopathology
  • Spinal Cord Neoplasms / complications*
  • Spinal Cord Neoplasms / physiopathology*
  • Spinal Cord Neoplasms / surgery
  • Thoracic Vertebrae
  • Treatment Outcome
  • Vascular Surgical Procedures / methods
  • Veins / abnormalities*
  • Veins / pathology
  • Veins / physiopathology