Spontaneous intramedullary hemorrhage of spinal hemangioblastoma: case report.

Abstract

Spontaneous hemorrhage of a spinal hemangioblastoma is a rare event. With limited reports in the literature, the risk of acute hemorrhage associated with these lesions is poorly understood. A 39-year-old man presented with paraplegia and bilateral upper-extremity weakness related to an acute intramedullary hemorrhage from a thoracic spinal hemangioblastoma. Magnetic resonance imaging revealed an intramedullary hemorrhage from T3 to T6 with prominent flow voids along the dorsal aspect of the spinal cord from T6 to T10. Magnetic resonance angiography of the thoracic spine indicated a prominent enhancing vessel along the dorsum of the thoracic cord. An emergency T3 to T8 laminoplasty was performed for evacuation of the hematoma and gross total resection of the lesion. Pathological analysis of the tumor biopsy confirmed the diagnosis of hemangioblastoma. The risk of spontaneous hemorrhage from a spinal hemangioblastoma is low. Spinal hemangioblastomas presenting with intramedullary hemorrhage tend to cause severe neurological deficits and have a poorer long-term prognosis compared with subarachnoid hemorrhage and nonhemorrhagic lesions.