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Vol. 10. Issue 5.
Pages 367-371 (January 1999)
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Vol. 10. Issue 5.
Pages 367-371 (January 1999)
Paraplejia en lactante por hematoma extradural debido a sangrado de cavernoma espinal
A case of paraplegia in a twenty month old child
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C. Alvarez Sastre, A. Pascual Martín-Gamero, F. Villarejo Ortega
Servicio de Neurocirugía. Hospital Infantil Niño Jesús. Madrid
P. Colomar Palmer*, A.M. Serrano González**, A. Martínez de Azagra Garde**
* Servicio de Anatomía Patológica. Hospital Infantil Niño Jesús. Madrid
** Servicio de Cuidados Intensivos. Hospital Infantil Niño Jesús. Madrid
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Resumen

Se presenta un caso excepcional de angioma cavernoso dural en una lactante con una historia de quince días de pérdida de fuerza progresiva y generalizada en los cuatro miembros. Ocho horas antes de su diagnóstico se estableció una parálisis completa en miembros inferiores y una paresia de los superiores. Tras realizar una R.N.M. y comprobarse lesión compresiva medular dorsal alta fue intervenida de urgencia y tras laminotomía se evacuó un hematoma epidural que se extendía longitudinalmente desde C7 a D4, apreciándose al quedar visible la duramadre un ovillo vascular en región dorso-lateral derecha de la misma. Estos vasos anómalos se cliparon, coagularon y extirparon, remitiendo el tejido a anatomía patológica. El resultado del estudio fue de cavernoma. Tres semanas después de la operación la niña se había recuperado totalmente de su paraplegía.

Palabras clave:
Compresión medular
Hematoma epidural espinal
Cavernoma
Paraplejia
Malformación arteria-venosa
Summary

The authors describe an exceptional case of a child with a thoracic extradural cavernoma. A twenty month old girl presented progressive tetraparesis and a established paraplegia eigth hours before the diagnosis. Magnetic Resonance Imaging showed medullary compression caused by an intraspinal mass adjacent to the intravertebral spaces C7–D4. A laminotomy DI–D4 was performed as an emergency procedure.

An organized epidural hematoma was removed followed by resection of a vascular nidus on the duramater at the level of D1. Three weeks after surgery the patient fully recovered from paraplegia.

Key words:
Spinal cord compression
Spinal epidural hematoma
Cavernoma
Paraplegia
Arteriovenous malformation

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