Capillary hemangioma of the cauda equina presenting with radiculopathy and papilledema

A 42-year-old, non-obese man with a three-month history of headache, pulsatile tinnitus, transient visual obscurations, and scintillations later developed low back pain with right lower extremity radiation. Brain MRI and magnetic resonance venography were normal, but spine MRI revealed a mass in the...

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Bibliographic Details
Main Author: Ghazi, Nicola G. (author)
Other Authors: Jane, John A. (author), Beatriz, Lopes M. (author), Newman, Steven A. (author)
Format: article
Published: 2006
Online Access:http://hdl.handle.net/10725/10814
http://dx.doi.org/10.1097/01.wno.0000222973.55486.d2
http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php
https://oce.ovid.com/article/00041327-200606000-00004/HTML
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Summary:A 42-year-old, non-obese man with a three-month history of headache, pulsatile tinnitus, transient visual obscurations, and scintillations later developed low back pain with right lower extremity radiation. Brain MRI and magnetic resonance venography were normal, but spine MRI revealed a mass in the cauda equina. Neuro-ophthalmologic examination disclosed bilateral optic disc edema with normal visual function. During spine surgery, cerebrospinal fluid, released under high pressure despite prior hyperventilation, contained a glucose level of 51 mg/dl and a protein level of 1840 mg/dl. Histologic and immunohistochemical features of the lesion were compatible with a capillary hemangioma. Although spinal cord tumors have been associated with papilledema, this is the first report of a capillary hemangioma of the cauda equina in this context. If papilledema is present, spinal cord imaging should be performed when lumbar puncture discloses unexplained protein elevation and in cases that lack clinical features typical of idiopathic intracranial hypertension.