Case report of cavernous hemangioma with a 4 year follow up

Cavernous hemangiomas are vascular malformations that can affect any part of the central nervous system. In general, epidural hemangiomas are secondary extensions of spinal lesions. These tumors grow slowly and are expressed as slow spinal cord compression syndromes, radiculopathy, or both. History, clinical examination, routine radiographs, MRI, and histopathologic studies are aids to a definitive diagnosis. This is a 61-year-old chronic smoker with a history of cholecystectomy in 2017. History of the disease: dates to 1 month by a progressive installation of heaviness of the left lower limb, then of the right one 15 days later. The state was complicated one week before his admission by sphincter disorders such as urinary leakage. Clinically, the patient walked with assistance, with a paraparesis of the two lower limbs at 4/5 on muscle testing, with a posterior cord syndrome, a D6 sensory level and normal osteotendinous reflexes. Spinal cord MRI showed a tissue-like process at D6-D7 extra-medullary extradural. Spinal cavernous extradural hemangioma is a frequent lesion, represented by a malformation of the microcirculation, whose diagnosis has become easier with the advent of MRI, revealed essentially by a spinal cord compression syndrome, whose evolution is favorable if treated in time. •This article presents a case of a dorsal epidural cavernous hemangioma. The clinical examination revealed a posterior cord syndrome associated with sphincter disorders such as urinary leakage. The medullary MRI confirmed the suspected diagnosis of medullary compression.•The total removal of the tumor was done, the diagnosis of cavernous hemangioma was suspected intraoperatively, and confirmed in anatomopathological examination.•The follow up done up to 4 years showed the complete recovery of the patient showing the importance of time-based care.