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Pregnancy related symptomatic vertebral hemangioma.

Authors
  • Gupta, Meena1
  • Nayak, Rajeev1
  • Singh, Hukum2
  • Khwaja, Geeta1
  • Chowdhury, Debashish1
  • 1 Department of Neurology, GB Pant Hospital, New Delhi, India. , (India)
  • 2 Department of Neurosurgery, GB Pant Hospital, New Delhi, India. , (India)
Type
Published Article
Journal
Annals of Indian Academy of Neurology
Publisher
Medknow Publications
Publication Date
Jan 01, 2014
Volume
17
Issue
1
Pages
120–122
Identifiers
DOI: 10.4103/0972-2327.128577
PMID: 24753678
Source
Medline
Keywords
License
Unknown

Abstract

Vertebral hemangiomas are benign vascular tumors of the spine that remain asymptomatic in most cases and incidentally encountered on imaging. Rarely, altered hemodynamic and hormonal changes during pregnancy may expand these benign lesions resulting in severe cord compression. The management of symptomatic vertebral hemangioma during pregnancy is controversial as modalities like radiotherapy and embolization are not suitable and surgery during pregnancy has a risk of preterm labor. Few cases of pregnancy related symptomatic vertebral hemangioma with marked epidural component have been reported in the literature. We report a case of 23-year-old primigravida who developed rapidly progressive paraparesis at 28 weeks of gestation and spine magnetic resonance imaging (MRI) revealed upper thoracic vertebral hemangioma with extensive extra-osseous extension and spinal cord compression. Laminectomy and surgical decompression of the cord was performed at 32 weeks of the pregnancy. There was significant improvement in muscle power after a week of surgery. Six weeks postoperatively she delivered a full term normal baby with subsequent improvement of neurologic deficit. Repeat MRI of dorsal spine performed at 3 months postoperatively showed reduced posterior and anterior epidural components of vertebral hemangioma.

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