Cavernoma of cervical cord

Case contributed by Frank Gaillard
Diagnosis almost certain

Presentation

Trauma. Knocked off bike. No neurology.

Patient Data

Age: 35 Years
ct

A vague region of increased density is seen in the cord at the level of C2, which may be artefact. 

There are transverse fractures through the lamina bilaterally at both the C7 and T1 levels. These are mildly (3 mm) displaced. 

mri

A well-circumscribed intramedullary lesion located at the level of C2, with characteristic features of a cavernous malformation.

C7 and T1 spinous process and laminar fractures as described on CT with expected soft tissue changes but without ligamentous disruption elsewhere.

Case Discussion

Characteristic appearances of a spinal cavernoma at C2. The main differential is that of a spinal ependymoma, and contrast-enhanced scan would be helpful in excluding this, by demonstrating no enhancing component (subsequently performed, but not available). 

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