Case Reports Management of Spinal Cord Cavernous Haemangioma 1. Department of Neuroscience, Division of Neurosurgery and Department of Radiology, King Abdullah University Hospital, Jordan University of Science and Technology, Irbid, Jordan. * Correspondence should be addressed to: Prof. Mohamed Barbarawi Division of neurosurgery, Department of Neuroscience Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan. E mail: dr_barbarawi@yahoo.com © 2009 DAR Publishers/ University of Jordan. All Rights Reserved. Mohamed Al Barbarawi,* 1 Suhair Qudsieh, 1 Hana Qudsieh 1 Abstract Cavernous haemangioma (CH) is a vascular malformation described as sinusoidal vascular channels located within the neural tissue but lacking intervening neural elements. Although spinal cord is not a frequent site for these lesions, the spinal cord cavernous haemangioma is currently encountered more frequently with magnetic resonance imaging. Management of both symptomatic and asymptomatic intramedullary cavernous haemangioma is a matter of debate as these lesions may cause a devastating spinal cord dysfunction. We present a young patient with thoracic intramedullary cavernous haemangioma who first presented with two episodes of transient paraparesis before he had a major intramedullary bleeding that rendered him in paraparesis and incontinence. We emphasize to consider early surgical resection as soon as possible to prevent potentially irreversible spinal cord damage secondary to a large or recurrent small bleedings. Keywords: Cavernous haemangioma (CH), intramedullary, haemosiderin, surgical removal. (J Med J 2009; Vol. 43 (2):129-133) Received Accepted May 6, 2008 August 28, 2008 Introduction Cavernous haemangiomas (or cavernoma) are congenital vascular hamartomas located within the neural tissue. It can occur throughout the central nervous system. Cerebral hemispheres and brainstem are usually the favorable locations. Whereas, spinal cord lesions are uncommon. Vertebral body cavernous haemangiomas is encountered frequently and usually asymptomatic in the vast majority of cases; occasionally these lesions may extend into the extradural or even into the intradural spaces, hence; compromising the neural tissues. 1-7 Spinal cord CH may be silent and may be discovered incidentally; but they usually have propensity for rupture and causing haematomyelia. Old bleedings result in haemosiderin deposit and gliotic reaction around the lesion. The treatment of choice for these lesions is total surgical resection but this may not be applicable in all cases. 8- 10 In this communication, we present a case of thoracic haematomyelia due to cavernous haemangioma, the patient underwent a total surgical resection of the lesion, and we then discussed the spinal cord cavernous haemangioma presentation and management options. Case Report A 19-year-old male was referred to our neurosurgical services with a two-day history of sudden onset of severe low back pain and rapid