case_images: PMC11380891_01
case_images: (a) Preoperative T2 mid-sagittal magnetic resonance imaging (MRI) reveals the 1.8 x 1.0 cm expansile cavernoma with a fluid level, suggesting recent hemorrhage. (b) Preoperative T2 axial MRI demonstrated the same lesion.
case_images: SNI-15-292-g001.jpg
case_images: PMC11380891_01_SNI-15-292-g001.jpg
case_images: F1
case_images: T8 region consistent with a CM. This lesion extended to the dorsal and dorsolateral region on axial images [Figure 1a and b].
case_images: An intraoperative owl's eye view through the tubular retractor visualizing the intramedullary lesion. The dorsal rootlets are clearly visualized, demarcating the dorsal root entry zone.
case_images: SNI-15-292-g002.jpg
case_images: PMC11380891_01_SNI-15-292-g002.jpg
case_images: F2
case_images: The arachnoid was then dissected, and dorsal rootlets and dentate ligament were identified. This allowed for the visualization of the pial surface as well as the expansile lesion marked by subacute and chronic blood products [Figure 2].
case_images: The dashed line in this figure represents the location of the myelotomy made just lateral and longitudinal to the fasciculus gracilis along the dorsal root entry zone.
case_images: SNI-15-292-g003.jpg
case_images: PMC11380891_01_SNI-15-292-g003.jpg
case_images: F3
case_images: A one centimeter longitudinal myelotomy was made along the dorsal root entry zone (DREZ) with a diamond knife under high-power magnification [Figure 3].
case_images: (a) Postoperative T2 mid-sagittal magnetic resonance imaging (MRI) at 18 month follow-up reveals resection of the lesion with small region of hemosiderin deposition. (b) Postoperative T2 axial MRI at same 18 month follow-up.
case_images: SNI-15-292-g004.jpg
case_images: PMC11380891_01_SNI-15-292-g004.jpg
case_images: F4
case_images: An MRI of the thoracic spine at his last follow-up demonstrated total resection of the CM with a small area of residual myelomalacia with hemosiderin staining and mild focal cord atrophy [Figure 4a and b].