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Hemorrhage of cavernous malformations during pregnancy and in the peripartum period: causal or coincidence? Case report and review of the literature Safavi-Abbasi S; Feiz-Erfan I; Spetzler RF; Kim L; Dogan S; Porter RW; Sonntag VKNeurosurg Focus 2006[Jul]; 21 (1): e12There 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.|Adult[MESH]|Cesarean Section[MESH]|Disease Progression[MESH]|Early Diagnosis[MESH]|Emergency Treatment/standards[MESH]|Female[MESH]|Hemangioma, Cavernous, Central Nervous System/*complications/*physiopathology/surgery[MESH]|Hemorrhage/etiology/prevention & control/surgery[MESH]|Humans[MESH]|Magnetic Resonance Imaging[MESH]|Neurosurgical Procedures/methods[MESH]|Paresthesia/etiology/physiopathology[MESH]|Pregnancy[MESH]|Pregnancy Complications, Neoplastic/diagnosis/*etiology/physiopathology[MESH]|Spinal Cord Neoplasms/*complications/*physiopathology/surgery[MESH]|Spinal Cord/blood supply/*pathology/physiopathology[MESH]|Thoracic Vertebrae[MESH]|Treatment Outcome[MESH]|Vascular Surgical Procedures/methods[MESH]|Veins/*abnormalities/pathology/physiopathology[MESH] |
