Spinal cavernous malformation (CM) is a rare condition that can result in spinal cord dysfunction after hemorrhage, manifesting as symptoms such as radicular pain and intermittent claudication.
MRI is considered the most valuable imaging modality for spinal CM. It can clearly demonstrate signal changes related to hemorrhagic components at different stages. Chronic recurrent bleeding and acute fresh bleeding within the lesion, containing free methemoglobin, generally exhibit high signal intensity on all imaging sequences. Angiography is typically negative and is used to differentiate CM from arteriovenous malformations.
Surgical resection is the primary treatment for spinal CM, especially for patients with significant symptoms. The treatment approach for asymptomatic CMs remains controversial. Considering the annual hemorrhage rate of up to 4.5%, along with the safety and efficacy of surgical resection, the risk of neurological damage from rebleeding is believed to significantly outweigh the risks associated with surgery. Consequently, surgical intervention is usually warranted if the lesion shows outward growth or if progressive and severe neurological dysfunction occurs.