{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T06:15:24Z","timestamp":1769926524146,"version":"3.49.0"},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,8,11]]},"abstract":"\n BACKGROUND<\/jats:title>\n Cavernous malformations (CMs) are vascular malformations characterized by enlarged, thin-walled blood vessels composed of dysplastic endothelial cells and pericytes within a loose extracellular matrix. Endothelial cell dysplasia leads to increased permeability and portends an increased risk of hemorrhage within these malformations, and hemorrhage often manifests with acute-onset neurological deficits due to mass effect and irritation of surrounding neural tissue within the brain and spinal cord.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n A 5-month-old male presented with concern for possible tethered cord syndrome in the setting of forked gluteal cleft and lower extremity hyperreflexia. He was ultimately determined to have three intramedullary spinal CMs. These were resected with laminoplasty performed. Follow-up imaging demonstrated preservation of spinal alignment and no intraspinal lesion recurrence, with corresponding improvement in the patient\u2019s neurological strength examination despite some persistent motor developmental milestone delay.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n Hemorrhage and rehemorrhage rates of intramedullary spinal CMs are higher in the pediatric population than in the adult population. Hence, early resection of these lesions, when feasible, reduces the risk of long-term neurological deficit. Resection in infancy can be augmented by laminoplasty to preserve the posterior tension band within the spinal column, promote bony regrowth, and significantly reduce the risk of delayed deformity.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE2557<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case2557","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T23:43:49Z","timestamp":1754955829000},"source":"Crossref","is-referenced-by-count":0,"title":["Resection of multiple intramedullary spinal cord cavernous malformations in infancy: illustrative case"],"prefix":"10.3171","volume":"10","author":[{"given":"Luke","family":"Silveira","sequence":"first","affiliation":[{"name":"Neurosurgery Department, The University of Vermont Medical Center, Burlington, Vermont"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie","family":"Limoges","sequence":"additional","affiliation":[{"name":"Neurosurgery Division, Valley Children\u2019s Healthcare, Madera, California"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"11","key":"bib1","series-title":"Eur Spine J","first-page":"3119","article-title":"A systematic review on the outcome of intramedullary spinal cord cavernous malformations","volume":"31","year":"2022","unstructured":"AsimakidouEMeszarosLTAnestisDMTsitsopoulosPP. A systematic review on the outcome of intramedullary spinal cord cavernous malformations. Eur Spine J. 2022;31(11):3119-3129."},{"issue":"1","key":"bib2","series-title":"Circ Res","first-page":"195","article-title":"Cerebral cavernous malformation: from mechanism to therapy","volume":"129","author":"Snellings","year":"2021","unstructured":"SnellingsDAHongCCRenAA Cerebral cavernous malformation: from mechanism to therapy. Circ Res. 2021;129(1):195-215."},{"issue":"4","key":"bib3","series-title":"Pediatr Neurosurg","first-page":"210","article-title":"Spinal cavernoma in an infant: a rare pathological entity with an atypical presentation","volume":"55","author":"Gendle","year":"2020","unstructured":"Gendle CSalunke PKarthigeyan MGupta K.Spinal cavernoma in an infant: a rare pathological entity with an atypical presentation. Pediatr Neurosurg. 2020;55(4):210-214."},{"key":"bib4","series-title":"Front Neurol","first-page":"672","article-title":"Spinal cavernomas: outcome of surgically treated 10 patients","volume":"8","author":"Sun","year":"2017","unstructured":"SunIPamirMN.Spinal cavernomas: outcome of surgically treated 10 patients. Front Neurol. 2017;8:672."},{"issue":"4","key":"bib5","series-title":"J Neurosurg Spine","first-page":"662","article-title":"Surgical outcomes and natural history of intramedullary spinal cord cavernous malformations: a single-center series and meta-analysis of individual patient data: clinic article","volume":"21","author":"Badhiwala","year":"2014","unstructured":"BadhiwalaJHFarrokhyarFAlhazzaniW Surgical outcomes and natural history of intramedullary spinal cord cavernous malformations: a single-center series and meta-analysis of individual patient data: clinic article. J Neurosurg Spine. 2014;21(4):662-676."},{"issue":"1","key":"bib6","series-title":"Neurosurg Focus","first-page":"e10","article-title":"Clinical presentation and optimal management for intramedullary cavernous malformations","volume":"21","author":"Jallo","year":"2006","unstructured":"JalloGIFreedDZareckMEpsteinFKothbauerKF. Clinical presentation and optimal management for intramedullary cavernous malformations. Neurosurg Focus. 2006;21(1):e10."},{"key":"bib7","series-title":"Neuroradiology","first-page":"401","article-title":"Natural history of familial cerebral cavernous malformation syndrome in children: a multicenter cohort study","volume":"2","author":"Geraldo","year":"2023","unstructured":"GeraldoAFAlvesCAPFLuisA Natural history of familial cerebral cavernous malformation syndrome in children: a multicenter cohort study. Neuroradiology. 2023;65(2):401-414."},{"issue":"1","key":"bib8","series-title":"Childs Nerv Syst","first-page":"235","article-title":"Clinical features and long-term outcomes of pediatric spinal cord cavernous malformation\u2014a report of 18 cases and literature review","volume":"37","author":"Zhang","year":"2021","unstructured":"Zhang LQiao GYang WShang AYu X.Clinical features and long-term outcomes of pediatric spinal cord cavernous malformation\u2014a report of 18 cases and literature review. Childs Nerv Syst. 2021;37(1):235-242."},{"issue":"3","key":"bib9","series-title":"J Korean Neurosurg Soc","first-page":"299","article-title":"Clinical features and treatment of pediatric cerebral cavernous malformations","volume":"67","year":"2024","unstructured":"PhiJHKimSK. Clinical features and treatment of pediatric cerebral cavernous malformations. J Korean Neurosurg Soc. 2024;67(3):299-307."},{"issue":"2","key":"bib10","series-title":"Eur J Hum Genet","first-page":"134","article-title":"Cerebral cavernous malformations: from molecular pathogenesis to genetic counselling and clinical management","volume":"20","author":"Haasdijk","year":"2012","unstructured":"HaasdijkRAChengCMaat-KievitAJDuckersHJ. Cerebral cavernous malformations: from molecular pathogenesis to genetic counselling and clinical management. Eur J Hum Genet. 2012;20(2):134-140."},{"issue":"7","key":"bib11","series-title":"JAMA Neurol","first-page":"801","article-title":"Population-based prevalence of cerebral cavernous malformations in older adults: Mayo Clinic study of aging","volume":"74","author":"Flemming","year":"2017","unstructured":"FlemmingKDGraff-RadfordJAakreJPopulation-based prevalence of cerebral cavernous malformations in older adults: Mayo Clinic study of aging. JAMA Neurol. 2017;74(7):801-805."},{"issue":"5","key":"bib12","series-title":"ACS Pharmacol Transl Sci","first-page":"266","article-title":"Rapamycin in cerebral cavernous malformations: what doses to test in mice and humans","volume":"5","author":"Hagan","year":"2022","unstructured":"HaganMJShenkarRRomanosSGRapamycin in cerebral cavernous malformations: what doses to test in mice and humans. ACS Pharmacol Transl Sci. 2022;5(5):266-277."},{"key":"bib13","series-title":"World Neurosurg","first-page":"e737","article-title":"Idiopathic scoliosis in children and adolescents: emerging techniques in surgical treatment","volume":"130","author":"Cheung","year":"2019","unstructured":"CheungZBSelverianSChoBHBallCJChoSKW.Idiopathic scoliosis in children and adolescents: emerging techniques in surgical treatment. World Neurosurg. 2019;130:e737-e742."},{"issue":"4","key":"bib14","series-title":"Neurosurg Focus","first-page":"E12","article-title":"Instrumented fusion for spinal deformity after laminectomy or laminoplasty for resection of intramedullary spinal cord tumors in pediatric patients","volume":"43","author":"Hersh","year":"2017","unstructured":"HershDSIyerRRGarzon-MuvdiTLiuAJalloGIGrovesML.Instrumented fusion for spinal deformity after laminectomy or laminoplasty for resection of intramedullary spinal cord tumors in pediatric patients. 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Front Bioeng Biotechnol. 2024;12:1353797."},{"issue":"3","key":"bib17","series-title":"Childs Nerv Syst","first-page":"369","article-title":"Multiple short-segment laminoplasties in children: a novel technique to avoid postoperative spinal deformity","volume":"24","author":"Steinbok","year":"2008","unstructured":"SteinbokP.Multiple short-segment laminoplasties in children: a novel technique to avoid postoperative spinal deformity. Childs Nerv Syst. 2008;24(3):369-372."},{"key":"bib18","series-title":"Front Surg.","first-page":"790593","article-title":"Comparison of laminoplasty vs. laminectomy for cervical spondylotic myelopathy: a systematic review and meta-analysis","volume":"8","author":"Zhao","year":"2022","unstructured":"ZhaoHRenRMaWComparison of laminoplasty vs. laminectomy for cervical spondylotic myelopathy: a systematic review and meta-analysis. 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Neuroradiology. 2023;65(2):401-414."},{"issue":"1","key":"bib8","series-title":"Childs Nerv Syst","first-page":"235","article-title":"Clinical features and long-term outcomes of pediatric spinal cord cavernous malformation\u2014a report of 18 cases and literature review","volume":"37","author":"Zhang","year":"2021","unstructured":"Zhang LQiao GYang WShang AYu X.Clinical features and long-term outcomes of pediatric spinal cord cavernous malformation\u2014a report of 18 cases and literature review. Childs Nerv Syst. 2021;37(1):235-242."},{"issue":"3","key":"bib9","series-title":"J Korean Neurosurg Soc","first-page":"299","article-title":"Clinical features and treatment of pediatric cerebral cavernous malformations","volume":"67","year":"2024","unstructured":"PhiJHKimSK. Clinical features and treatment of pediatric cerebral cavernous malformations. J Korean Neurosurg Soc. 2024;67(3):299-307."},{"issue":"2","key":"bib10","series-title":"Eur J Hum Genet","first-page":"134","article-title":"Cerebral cavernous malformations: from molecular pathogenesis to genetic counselling and clinical management","volume":"20","author":"Haasdijk","year":"2012","unstructured":"HaasdijkRAChengCMaat-KievitAJDuckersHJ. Cerebral cavernous malformations: from molecular pathogenesis to genetic counselling and clinical management. Eur J Hum Genet. 2012;20(2):134-140."},{"issue":"7","key":"bib11","series-title":"JAMA Neurol","first-page":"801","article-title":"Population-based prevalence of cerebral cavernous malformations in older adults: Mayo Clinic study of aging","volume":"74","author":"Flemming","year":"2017","unstructured":"FlemmingKDGraff-RadfordJAakreJPopulation-based prevalence of cerebral cavernous malformations in older adults: Mayo Clinic study of aging. JAMA Neurol. 2017;74(7):801-805."},{"issue":"5","key":"bib12","series-title":"ACS Pharmacol Transl Sci","first-page":"266","article-title":"Rapamycin in cerebral cavernous malformations: what doses to test in mice and humans","volume":"5","author":"Hagan","year":"2022","unstructured":"HaganMJShenkarRRomanosSGRapamycin in cerebral cavernous malformations: what doses to test in mice and humans. ACS Pharmacol Transl Sci. 2022;5(5):266-277."},{"key":"bib13","series-title":"World Neurosurg","first-page":"e737","article-title":"Idiopathic scoliosis in children and adolescents: emerging techniques in surgical treatment","volume":"130","author":"Cheung","year":"2019","unstructured":"CheungZBSelverianSChoBHBallCJChoSKW.Idiopathic scoliosis in children and adolescents: emerging techniques in surgical treatment. World Neurosurg. 2019;130:e737-e742."},{"issue":"4","key":"bib14","series-title":"Neurosurg Focus","first-page":"E12","article-title":"Instrumented fusion for spinal deformity after laminectomy or laminoplasty for resection of intramedullary spinal cord tumors in pediatric patients","volume":"43","author":"Hersh","year":"2017","unstructured":"HershDSIyerRRGarzon-MuvdiTLiuAJalloGIGrovesML.Instrumented fusion for spinal deformity after laminectomy or laminoplasty for resection of intramedullary spinal cord tumors in pediatric patients. Neurosurg Focus. 2017;43(4):E12."},{"issue":"5","key":"bib15","series-title":"Neurosurgery","first-page":"1005","article-title":"Short-term progressive spinal deformity following laminoplasty versus laminectomy for resection of intradural spinal tumors: analysis of 238 patients","volume":"66","author":"McGirt","year":"2010","unstructured":"McGirtMJGarc\u00e9s-AmbrossiGLParkerSLShort-term progressive spinal deformity following laminoplasty versus laminectomy for resection of intradural spinal tumors: analysis of 238 patients. Neurosurgery. 2010;66(5):1005-1012."},{"key":"bib16","series-title":"Front Bioeng Biotechnol","first-page":"1353797","article-title":"Biomechanical evaluation on a new type of vertebral titanium porous mini-plate and mechanical comparison between cervical open-door laminoplasty and laminectomy: a finite element analysis","volume":"12","author":"Lin","year":"2024","unstructured":"LinZLinDXuL Biomechanical evaluation on a new type of vertebral titanium porous mini-plate and mechanical comparison between cervical open-door laminoplasty and laminectomy: a finite element analysis. Front Bioeng Biotechnol. 2024;12:1353797."},{"issue":"3","key":"bib17","series-title":"Childs Nerv Syst","first-page":"369","article-title":"Multiple short-segment laminoplasties in children: a novel technique to avoid postoperative spinal deformity","volume":"24","author":"Steinbok","year":"2008","unstructured":"SteinbokP.Multiple short-segment laminoplasties in children: a novel technique to avoid postoperative spinal deformity. Childs Nerv Syst. 2008;24(3):369-372."},{"key":"bib18","series-title":"Front Surg.","first-page":"790593","article-title":"Comparison of laminoplasty vs. laminectomy for cervical spondylotic myelopathy: a systematic review and meta-analysis","volume":"8","author":"Zhao","year":"2022","unstructured":"ZhaoHRenRMaWComparison of laminoplasty vs. laminectomy for cervical spondylotic myelopathy: a systematic review and meta-analysis. Front Surg. 2022;8:790593."},{"issue":"1","key":"bib19","series-title":"J Neurosurg Pediatr","first-page":"57","article-title":"Incidence of spinal deformity after resection of intramedullary spinal cord tumors in children who underwent laminectomy compared with laminoplasty","volume":"1","author":"McGirt","year":"2008","unstructured":"McGirt MJChaichana KLAtiba AIncidence of spinal deformity after resection of intramedullary spinal cord tumors in children who underwent laminectomy compared with laminoplasty. 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