A Cervical Nerve Root Cavernoma – Atypical Presentation With Diagnostic Dilemma Atypical Presentation With Diagnostic Dilemma
International Clinical Neuroscience Journal,
Vol. 10 No. 1 (2023),
15 Dey 2023
,
Page e2
Abstract
Background
Spinal cavernous angiomas are uncommon vascular malformations in spine accounting for 5-12% of all spinal vascular lesions. When present in intradural extra-medullary location, these usually present with radicular pain and neurological deficits due to mass effect (myelopathy). We here present an atypical presentation of cavernous angioma in a 54-year-old male with tinnitus, headache and sensorineural hearing loss. We have also reviewed 51 cases of intradural extramedullary cavernous angiomas including our case with respect to demographic and clinical profile.
Case Description
A 54-year-old male presented with tinnitus in left ear and occipital headache with neck pain and slight weakness of left-hand grip along with atrophy of thenar muscles. His PTA examination revealed mild left sensorineural earing loss. MRI of cervical spine showed T2WI heterogeneously hyperintense left intradural extramedullary lesion at C7 vertebral body level. It was avidly enhancing with contrast. Patient underwent C7 laminectomy with a midline durotomy and complete excision of the lesion under neuromonitoring with sacrifice of the C8 sensory root. His symptoms improved following the surgery.
Conclusions
Spinal nerve root cavernomas are extremely rare. They usually present with radicular or myelopathy symptoms due to compression. Repeated rupture or micro-bleeds can cause raised intracranial pressure features along with cranial nerve deficits. The diagnostic workup is not straight forward in these latter cases and the presence of cavernoma may be an unusual finding. The diagnosis of a cavernoma in an unusual location in the presence of cranial nerve dysfunction needs a high degree of diagnostic suspicion. Majority of these cavernomas have a nerve root origin or attachment. The optimal treatment is microsurgical en bloc resection which leads to an effective resolution of both the symptoms.
Keywords:
- Spinal cavernous angiomas
- Nerve Root Cavernoma
- intradural extra-medullary cavernoma
- Spinal cavernoma
- Cavernoma and Hearing loss
- Cavernoma and Tinnitus
How to Cite
1.
Moolchandani S, Tyagi G, Yagnick N, Sinha S, Mehta VS. A Cervical Nerve Root Cavernoma – Atypical Presentation With Diagnostic Dilemma: Atypical Presentation With Diagnostic Dilemma. Int Clin Neurosci J [Internet]. 2023 Jan. 31 [cited 2025 Mar. 21];10(1):e2. Available from: https://journals.sbmu.ac.ir/neuroscience/article/view/39028
References
References
1. Nowak DA, Widenka DC. Spinal intradural capillary haemangioma: A review. Eur Spine J. 2001;10(6):464-472. doi:10.1007/s005860100296
2. Ogilvy CS, Louis DN, Ojemann RG. Intramedullary cavernous angiomas of the spinal cord: Clinical presentation, pathological features, and surgical management. Neurosurgery. 1992;31(2):219-230. doi:10.1227/00006123-199208000-00007
3. Zevgaridis D, Medele RJ, Hamburger C, Steiger HJ, Reulen HJ. Cavernous haemangiomas of the spinal cord. A review of 117 cases. Acta Neurochir (Wien). 1999;141(3):237-245. doi:10.1007/s007010050293
4. Khalatbari MR, Abbassioun K, Amirjmshidi A. Solitary spinal epidural cavernous angioma: Report of nine surgically treated cases and review of the literature. Eur Spine J. 2013;22(3):542-547. doi:10.1007/s00586-012-2526-2
5. Shin JH, Lee HK, Jeon SR, Park SH. Spinal intradural capillary hemangioma: MR findings. AJNR Am J Neuroradiol. 2000;21(5):954-956.
6. Yoo A, Jou J, Klopfenstein JD, Kattah JC. Focused neuro-otological review of superficial siderosis of the central nervous system. Front Neurol. 2018;9(MAY). doi:10.3389/fneur.2018.00358
7. Mastronardi L, Ferrante L, Scarpinati M, Gagliardi FM, Celli P, Fortuna A. Intradural extramedullary cavernous angioma: case report. Neurosurgery. 1991;29(6):924-926. doi:10.1097/00006123-199112000-00023
8. Ghobrial GM, Liounakos J, Starke RM, Levi AD. Surgical Treatment of Vascular Intramedullary Spinal Cord Lesions. Cureus. August 2018. doi:10.7759/cureus.3154
9. Hirsch JF, Pradat P, David M. [Cavernous angioma of the cauda equina]. Neurochirurgie. 11(4):323-327.
10. A P, F LR. Raro case di angiocavernoma della cauda. Men Soc Tos Um Chir. 1966;27:679-696.
11. Heimberger K, Schnaberth G, Koos W, Pendl G, Auff E. Spinal cavernous haemangioma (intradural-extramedullary) underlying repeated subarachnoid haemorrhage. J Neurol. 1982;226(4):289-293. doi:10.1007/BF00313403
12. Ueda S, Saito A, Inomori S, Kim I. Cavernous angioma of the cauda equina producing subarachnoid hemorrhage. Case report. J Neurosurg. 1987;66(1):134-136. doi:10.3171/jns.1987.66.1.0134
13. Pagni CA, Canavero S, Forni M. Report of a cavernoma of the cauda equina and review of the literature. Surg Neurol. 1990;33(2):124-131. doi:10.1016/0090-3019(90)90021-g
14. Ramos F, de Toffol B, Aesch B, Jan M. Hydrocephalus and cavernoma of the cauda equina. Neurosurgery. 1990;27(1):139-142. doi:10.1097/00006123-199007000-00023
15. Mori K, Ishii H, Tomita Y, Nakajima K, Morimoto K, Maeda M. Intradural-extramedullary Spinal Cavernous Angioma. Neurol Med Chir (Tokyo). 1991;31(9):593-596. doi:10.2176/nmc.31.593
16. Acciarri N, Padovani R, Pozzati E, Gaist G, Manetto V. Spinal cavernous angioma: A rare cause of subarachnoid hemorrhage. Surg Neurol. 1992;37(6):453-456. doi:10.1016/0090-3019(92)90134-9
17. Sharma R, Rout D, Radhakrishnan VV. Intradural spinal cavernomas. Br J Neurosurg. 1992;6(4):351-356. doi:10.3109/02688699209023794
18. Bruni P, Massari A, Greco R, Hernandez R, Oddi G, Chiappetta F. Subarachnoid hemorrhage from cavernous angioma of the cauda equina: Case report. Surg Neurol. 1994;41(3):226-229. doi:10.1016/0090-3019(94)90127-9
19. Cervoni L, Celli P, Gagliardi FM. Cavernous angioma of the cauda equina: report of two cases and review of the literature. Neurosurg Rev. 1995;18(4):281-283. doi:10.1007/bf00383882
20. Prakash Rao G, Bhaskar G, Hemaratnan A, Srinivas T V. Spinal intradural extramedullary cavernous angiomas: Report of four cases and review of the literature. Br J Neurosurg. 1997;11(3):228-232. doi:10.1080/02688699746294
21. Duke BJ, Levy AS, Lillehei KO. Cavernous angiomas of the cauda equina: case report and review of the literature. Surg Neurol. 1998;50(5):442-445. doi:10.1016/s0090-3019(97)00354-6
22. Holtzman RNN, Brisson PM, Pearl RE, Gruber ML. Lobular capillary hemangioma of the cauda equina: Case report. J Neurosurg. 1999;90(4 SUPPL.):239-241. doi:10.3171/spi.1999.90.2.0239
23. Nowak DA, Gumprecht H, Stölzle A, Lumenta CB. Intraneural growth of a capillary haemangioma of the cauda equina. Acta Neurochir (Wien). 2000;142(4):463-468. doi:10.1007/s007010050458
24. Roncaroli F, Scheithauer BW, Deen HG. Multiple hemangiomas (hemangiomatosis) of the cauda equina and spinal cord: Case report. J Neurosurg. 2000;92(2 SUPPL.):229-232. doi:10.3171/spi.2000.92.2.0229
25. Yoon Choi B, Chang K-H, Choe G, et al. Spinal Intradural Extramedullary Capillary Hemangioma: MR Imaging Findings. Am J Neuroradiol. 2001;22(4).
26. Nozaki K, Inomoto T, Takagi Y, Hashimoto N. Spinal intradural extramedullary cavernous angioma. J Neurosurg Spine. 2003;99(3):316-319. doi:10.3171/spi.2003.99.3.0316
27. Falavigna A, Neto OR, Nasser Dos Santos JA, Patriani Ferraz FA. Cavernous angioma of the cauda equina: Case report. Arq Neuropsiquiatr. 2004;62(2 B):531-534. doi:10.1590/S0004-282X2004000300029
28. Abdullah DC, Raghuram K, Phillips CD, Jane JA, Miller B. Thoracic Intradural Extramedullary Capillary Hemangioma. Am J Neuroradiol. 2004;25(7).
29. Crispino M, Vecchioni S, Galli G, Olivetti L. Spinal intradural extramedullary haemangioma: MRI and neurosurgical findings. Acta Neurochir (Wien). 2005;147(11):1195-1198. doi:10.1007/s00701-005-0621-4
30. Kim KJ, Lee JY, Lee SH. Spinal intradural capillary hemangioma. Surg Neurol. 2006;66(2):212-214. doi:10.1016/j.surneu.2005.11.018
31. Er U, Yigitkanli K, Simsek S, Adabag A, Bavbek M. Spinal intradural extramedullary cavernous angioma: Case report and review of the literature. Spinal Cord. 2007;45(9):632-636. doi:10.1038/sj.sc.3101990
32. Rachinger J, Buslei R, Engelhorn T, Doerfler A, Strauss C. Intradural-extramedullary cavernous hemangioma of the left motor root C7 - Case report and update of the literature. Zentralbl Neurochir. 2006;67(3):144-148. doi:10.1055/s-2006-933362
33. Caroli E, Acqui M, Trasimeni G, Di Stefano D, Ferrante L. A case of intraroot cauda equina cavernous angioma: Clinical considerations. Spinal Cord. 2007;45(4):318-321. doi:10.1038/sj.sc.3101964
34. Cecchi PC, Rizzo P, Faccioli F, Bontempini L, Schwarz A, Bricolo A. Intraneural cavernous malformation of the cauda equina. J Clin Neurosci. 2007;14(10):984-986. doi:10.1016/j.jocn.2006.06.015
35. Miyake S, Uchihashi Y, Takaishi Y, Sakagami Y, Kohmura E. Multiple cavernous angiomas of the cauda equina - Case report. Neurol Med Chir (Tokyo). 2007;47(4):178-181. doi:10.2176/nmc.47.178
36. Kivelev J, Ramsey CN, Dashti R, Porras M, Tyyninen O, Hernesniemi J. Cervical intradural extramedullary cavernoma presenting with isolated intramedullary hemorrhage: Case report. J Neurosurg Spine. 2008;8(1):88-91. doi:10.3171/SPI-08/01/088
37. Chun SW, Kim SJ, Lee TH, Koo HS. Intra-root cavernous angioma of the cauda equina: A case report and review of the literature. J Korean Neurosurg Soc. 2010;47(4):291-294. doi:10.3340/jkns.2010.47.4.291
38. Jin YJ, Chung SB, Kim KJ, Kim HJ. Spinal intradural extramedullary cavernoma presenting with intracranial superficial hemosiderosis. J Korean Neurosurg Soc. 2011;49(6):377-380. doi:10.3340/jkns.2011.49.6.377
39. Nie QB, Chen Z, Jian FZ, Wu H, Ling F. Cavernous angioma of the cauda equina: A case report and systematic review of the literature. J Int Med Res. 2012;40(5):2001-2008. doi:10.1177/030006051204000542
40. Popescu M, Grigorean VT, Sinescu CJ, et al. Cauda equina intradural extramedullary cavernous haemangioma: Case report and review of the literature. Neurol Med Chir (Tokyo). 2013;53(12):890-895. doi:10.2176/nmc.cr2012-0309
41. Mataliotakis G, Perera S, Nagaraju S, Marchionni M, Tzerakis N. Intradural extramedullary cavernoma of a lumbar nerve root mimicking neurofibroma. A report of a rare case and the differential diagnosis. Spine J. 2014;14(12):e1-e7. doi:10.1016/j.spinee.2014.08.447
42. Katoh N, Yoshida T, Uehara T, Ito K, Hongo K, Ikeda SI. Spinal intradural extramedullary cavernous angioma presenting with superficial siderosis and hydrocephalus: A case report and review of the literature. Intern Med. 2014;53(16):1863-1867. doi:10.2169/internalmedicine.53.2378
43. Takata Y, Sakai T, Higashino K, Goda Y, Tezuka F, Sairyo K. Intradural Extramedullary Capillary Hemangioma in the Upper Thoracic Spine: A Review of the Literature. Case Rep Orthop. 2014;2014:1-6. doi:10.1155/2014/604131
44. Gaetano R. A Rare Case of Cavernous Angioma of the Cauda Equina with Spinal Subarachnoid Hemorrhage in a Patient with Multiple Brain Cavernomatosis. Case Report and Review of Literature. J Neurol Stroke. 2016;4(5). doi:10.15406/jnsk.2016.04.00140
45. Henderson F, Skipper DC, Patel S. Cervical spinal root cavernoma: case report and review. Br J Neurosurg. 2018;32(4):445-447. doi:10.1080/02688697.2016.1229753
46. Zhu K, He D. Intradural extramedullary capillary hemangioma: A case report and review of the literature. Oncol Lett. 2016;11(4):2896-2898. doi:10.3892/ol.2016.4320
47. Pétillon P, Wilms G, Raftopoulos C, Thierry Duprez &. Spinal intradural extramedullary cavernous hemangioma. 2073. doi:10.1007/s00234-018-2073-6
48. Apostolakis S, Mitropoulos A, Diamantopoulou K, Vlachos K. Cavernoma of the cauda equina. Surg Neurol Int. 2018;9(1). doi:10.4103/sni.sni_212_18
49. Ziechmann R, Zyck S, Krishnamurthy S, Galgano M. Intradural Extramedullary Thoracic Cavernoma in a Man with Familial Multiple Cavernomas. Cureus. August 2018. doi:10.7759/cureus.3115
50. Vicenty J, Fernandez-de Thomas R, Estronza S, Mayol-Del Valle M, Pastrana E. Cavernous malformation of a thoracic spinal nerve root: Case report and review of literature. Asian J Neurosurg. 2019;14(3):1033. doi:10.4103/ajns.ajns_249_18
1. Nowak DA, Widenka DC. Spinal intradural capillary haemangioma: A review. Eur Spine J. 2001;10(6):464-472. doi:10.1007/s005860100296
2. Ogilvy CS, Louis DN, Ojemann RG. Intramedullary cavernous angiomas of the spinal cord: Clinical presentation, pathological features, and surgical management. Neurosurgery. 1992;31(2):219-230. doi:10.1227/00006123-199208000-00007
3. Zevgaridis D, Medele RJ, Hamburger C, Steiger HJ, Reulen HJ. Cavernous haemangiomas of the spinal cord. A review of 117 cases. Acta Neurochir (Wien). 1999;141(3):237-245. doi:10.1007/s007010050293
4. Khalatbari MR, Abbassioun K, Amirjmshidi A. Solitary spinal epidural cavernous angioma: Report of nine surgically treated cases and review of the literature. Eur Spine J. 2013;22(3):542-547. doi:10.1007/s00586-012-2526-2
5. Shin JH, Lee HK, Jeon SR, Park SH. Spinal intradural capillary hemangioma: MR findings. AJNR Am J Neuroradiol. 2000;21(5):954-956.
6. Yoo A, Jou J, Klopfenstein JD, Kattah JC. Focused neuro-otological review of superficial siderosis of the central nervous system. Front Neurol. 2018;9(MAY). doi:10.3389/fneur.2018.00358
7. Mastronardi L, Ferrante L, Scarpinati M, Gagliardi FM, Celli P, Fortuna A. Intradural extramedullary cavernous angioma: case report. Neurosurgery. 1991;29(6):924-926. doi:10.1097/00006123-199112000-00023
8. Ghobrial GM, Liounakos J, Starke RM, Levi AD. Surgical Treatment of Vascular Intramedullary Spinal Cord Lesions. Cureus. August 2018. doi:10.7759/cureus.3154
9. Hirsch JF, Pradat P, David M. [Cavernous angioma of the cauda equina]. Neurochirurgie. 11(4):323-327.
10. A P, F LR. Raro case di angiocavernoma della cauda. Men Soc Tos Um Chir. 1966;27:679-696.
11. Heimberger K, Schnaberth G, Koos W, Pendl G, Auff E. Spinal cavernous haemangioma (intradural-extramedullary) underlying repeated subarachnoid haemorrhage. J Neurol. 1982;226(4):289-293. doi:10.1007/BF00313403
12. Ueda S, Saito A, Inomori S, Kim I. Cavernous angioma of the cauda equina producing subarachnoid hemorrhage. Case report. J Neurosurg. 1987;66(1):134-136. doi:10.3171/jns.1987.66.1.0134
13. Pagni CA, Canavero S, Forni M. Report of a cavernoma of the cauda equina and review of the literature. Surg Neurol. 1990;33(2):124-131. doi:10.1016/0090-3019(90)90021-g
14. Ramos F, de Toffol B, Aesch B, Jan M. Hydrocephalus and cavernoma of the cauda equina. Neurosurgery. 1990;27(1):139-142. doi:10.1097/00006123-199007000-00023
15. Mori K, Ishii H, Tomita Y, Nakajima K, Morimoto K, Maeda M. Intradural-extramedullary Spinal Cavernous Angioma. Neurol Med Chir (Tokyo). 1991;31(9):593-596. doi:10.2176/nmc.31.593
16. Acciarri N, Padovani R, Pozzati E, Gaist G, Manetto V. Spinal cavernous angioma: A rare cause of subarachnoid hemorrhage. Surg Neurol. 1992;37(6):453-456. doi:10.1016/0090-3019(92)90134-9
17. Sharma R, Rout D, Radhakrishnan VV. Intradural spinal cavernomas. Br J Neurosurg. 1992;6(4):351-356. doi:10.3109/02688699209023794
18. Bruni P, Massari A, Greco R, Hernandez R, Oddi G, Chiappetta F. Subarachnoid hemorrhage from cavernous angioma of the cauda equina: Case report. Surg Neurol. 1994;41(3):226-229. doi:10.1016/0090-3019(94)90127-9
19. Cervoni L, Celli P, Gagliardi FM. Cavernous angioma of the cauda equina: report of two cases and review of the literature. Neurosurg Rev. 1995;18(4):281-283. doi:10.1007/bf00383882
20. Prakash Rao G, Bhaskar G, Hemaratnan A, Srinivas T V. Spinal intradural extramedullary cavernous angiomas: Report of four cases and review of the literature. Br J Neurosurg. 1997;11(3):228-232. doi:10.1080/02688699746294
21. Duke BJ, Levy AS, Lillehei KO. Cavernous angiomas of the cauda equina: case report and review of the literature. Surg Neurol. 1998;50(5):442-445. doi:10.1016/s0090-3019(97)00354-6
22. Holtzman RNN, Brisson PM, Pearl RE, Gruber ML. Lobular capillary hemangioma of the cauda equina: Case report. J Neurosurg. 1999;90(4 SUPPL.):239-241. doi:10.3171/spi.1999.90.2.0239
23. Nowak DA, Gumprecht H, Stölzle A, Lumenta CB. Intraneural growth of a capillary haemangioma of the cauda equina. Acta Neurochir (Wien). 2000;142(4):463-468. doi:10.1007/s007010050458
24. Roncaroli F, Scheithauer BW, Deen HG. Multiple hemangiomas (hemangiomatosis) of the cauda equina and spinal cord: Case report. J Neurosurg. 2000;92(2 SUPPL.):229-232. doi:10.3171/spi.2000.92.2.0229
25. Yoon Choi B, Chang K-H, Choe G, et al. Spinal Intradural Extramedullary Capillary Hemangioma: MR Imaging Findings. Am J Neuroradiol. 2001;22(4).
26. Nozaki K, Inomoto T, Takagi Y, Hashimoto N. Spinal intradural extramedullary cavernous angioma. J Neurosurg Spine. 2003;99(3):316-319. doi:10.3171/spi.2003.99.3.0316
27. Falavigna A, Neto OR, Nasser Dos Santos JA, Patriani Ferraz FA. Cavernous angioma of the cauda equina: Case report. Arq Neuropsiquiatr. 2004;62(2 B):531-534. doi:10.1590/S0004-282X2004000300029
28. Abdullah DC, Raghuram K, Phillips CD, Jane JA, Miller B. Thoracic Intradural Extramedullary Capillary Hemangioma. Am J Neuroradiol. 2004;25(7).
29. Crispino M, Vecchioni S, Galli G, Olivetti L. Spinal intradural extramedullary haemangioma: MRI and neurosurgical findings. Acta Neurochir (Wien). 2005;147(11):1195-1198. doi:10.1007/s00701-005-0621-4
30. Kim KJ, Lee JY, Lee SH. Spinal intradural capillary hemangioma. Surg Neurol. 2006;66(2):212-214. doi:10.1016/j.surneu.2005.11.018
31. Er U, Yigitkanli K, Simsek S, Adabag A, Bavbek M. Spinal intradural extramedullary cavernous angioma: Case report and review of the literature. Spinal Cord. 2007;45(9):632-636. doi:10.1038/sj.sc.3101990
32. Rachinger J, Buslei R, Engelhorn T, Doerfler A, Strauss C. Intradural-extramedullary cavernous hemangioma of the left motor root C7 - Case report and update of the literature. Zentralbl Neurochir. 2006;67(3):144-148. doi:10.1055/s-2006-933362
33. Caroli E, Acqui M, Trasimeni G, Di Stefano D, Ferrante L. A case of intraroot cauda equina cavernous angioma: Clinical considerations. Spinal Cord. 2007;45(4):318-321. doi:10.1038/sj.sc.3101964
34. Cecchi PC, Rizzo P, Faccioli F, Bontempini L, Schwarz A, Bricolo A. Intraneural cavernous malformation of the cauda equina. J Clin Neurosci. 2007;14(10):984-986. doi:10.1016/j.jocn.2006.06.015
35. Miyake S, Uchihashi Y, Takaishi Y, Sakagami Y, Kohmura E. Multiple cavernous angiomas of the cauda equina - Case report. Neurol Med Chir (Tokyo). 2007;47(4):178-181. doi:10.2176/nmc.47.178
36. Kivelev J, Ramsey CN, Dashti R, Porras M, Tyyninen O, Hernesniemi J. Cervical intradural extramedullary cavernoma presenting with isolated intramedullary hemorrhage: Case report. J Neurosurg Spine. 2008;8(1):88-91. doi:10.3171/SPI-08/01/088
37. Chun SW, Kim SJ, Lee TH, Koo HS. Intra-root cavernous angioma of the cauda equina: A case report and review of the literature. J Korean Neurosurg Soc. 2010;47(4):291-294. doi:10.3340/jkns.2010.47.4.291
38. Jin YJ, Chung SB, Kim KJ, Kim HJ. Spinal intradural extramedullary cavernoma presenting with intracranial superficial hemosiderosis. J Korean Neurosurg Soc. 2011;49(6):377-380. doi:10.3340/jkns.2011.49.6.377
39. Nie QB, Chen Z, Jian FZ, Wu H, Ling F. Cavernous angioma of the cauda equina: A case report and systematic review of the literature. J Int Med Res. 2012;40(5):2001-2008. doi:10.1177/030006051204000542
40. Popescu M, Grigorean VT, Sinescu CJ, et al. Cauda equina intradural extramedullary cavernous haemangioma: Case report and review of the literature. Neurol Med Chir (Tokyo). 2013;53(12):890-895. doi:10.2176/nmc.cr2012-0309
41. Mataliotakis G, Perera S, Nagaraju S, Marchionni M, Tzerakis N. Intradural extramedullary cavernoma of a lumbar nerve root mimicking neurofibroma. A report of a rare case and the differential diagnosis. Spine J. 2014;14(12):e1-e7. doi:10.1016/j.spinee.2014.08.447
42. Katoh N, Yoshida T, Uehara T, Ito K, Hongo K, Ikeda SI. Spinal intradural extramedullary cavernous angioma presenting with superficial siderosis and hydrocephalus: A case report and review of the literature. Intern Med. 2014;53(16):1863-1867. doi:10.2169/internalmedicine.53.2378
43. Takata Y, Sakai T, Higashino K, Goda Y, Tezuka F, Sairyo K. Intradural Extramedullary Capillary Hemangioma in the Upper Thoracic Spine: A Review of the Literature. Case Rep Orthop. 2014;2014:1-6. doi:10.1155/2014/604131
44. Gaetano R. A Rare Case of Cavernous Angioma of the Cauda Equina with Spinal Subarachnoid Hemorrhage in a Patient with Multiple Brain Cavernomatosis. Case Report and Review of Literature. J Neurol Stroke. 2016;4(5). doi:10.15406/jnsk.2016.04.00140
45. Henderson F, Skipper DC, Patel S. Cervical spinal root cavernoma: case report and review. Br J Neurosurg. 2018;32(4):445-447. doi:10.1080/02688697.2016.1229753
46. Zhu K, He D. Intradural extramedullary capillary hemangioma: A case report and review of the literature. Oncol Lett. 2016;11(4):2896-2898. doi:10.3892/ol.2016.4320
47. Pétillon P, Wilms G, Raftopoulos C, Thierry Duprez &. Spinal intradural extramedullary cavernous hemangioma. 2073. doi:10.1007/s00234-018-2073-6
48. Apostolakis S, Mitropoulos A, Diamantopoulou K, Vlachos K. Cavernoma of the cauda equina. Surg Neurol Int. 2018;9(1). doi:10.4103/sni.sni_212_18
49. Ziechmann R, Zyck S, Krishnamurthy S, Galgano M. Intradural Extramedullary Thoracic Cavernoma in a Man with Familial Multiple Cavernomas. Cureus. August 2018. doi:10.7759/cureus.3115
50. Vicenty J, Fernandez-de Thomas R, Estronza S, Mayol-Del Valle M, Pastrana E. Cavernous malformation of a thoracic spinal nerve root: Case report and review of literature. Asian J Neurosurg. 2019;14(3):1033. doi:10.4103/ajns.ajns_249_18
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