Conservative Management and Early Intensive Rehabilitation Following Haemorrhage of a Thoracic Intramedullary Spinal Cord Cavernoma: A Case Report
Year: 2025
Type: article
Study design: Case Report
Abstract: Spinal cord cavernous malformations (SCCMs) are rare vascular malformations of the spinal cord that may present with acute neurological deterioration in the event of haemorrhage. We report the case of a 21-year-old woman who presented with sudden bilateral lower limb weakness and paraesthesia. She experienced a rapid neurological decline leading to paraplegia and urinary retention. MRI demonstrated a haemorrhagic intramedullary cavernoma at the T12 level with associated cord oedema. Surgical intervention was deferred in the acute phase, given the extent of haemorrhage-related oedema and unclear lesion margins, and conservative management was initiated alongside early intensive neurorehabilitation. The patient subsequently showed significant improvement, progressing from Modified McCormick grade 5 to grade 3 within weeks. By six months, she achieved independent transfers, ambulation with crutches, and functional independence in most activities of daily living, although bladder dysfunction persisted. Follow-up MRI showed a stable lesion with no further haemorrhage. This case illustrates that conservative management with early multidisciplinary neurorehabilitation may facilitate meaningful recovery while neurosurgical planning is underway.
Source: Cureus
DOI: 10.7759/cureus.98576
Authors: Dharaneswar Venugopal, Bahar G Yenidunya, Eleonora Bradaschia
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4417078151