[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-443474-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-443474-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","conservative-management-and-early-intensive-rehabilitation-following-haemorrhage-of-a-thoracic-intramedullary-spinal-cord-cavernoma-a-case-report","Conservative Management and Early Intensive Rehabilitation Following Haemorrhage of a Thoracic Intramedullary Spinal Cord Cavernoma - A Case Report","","Spinal cord cavernous malformations are rare vascular lesions that can cause acute neurological deterioration after haemorrhage. This case report describes a 21-year-old woman with sudden bilateral leg weakness and paraesthesia, progressing rapidly to paraplegia and urinary retention. MRI confirmed a T12 intramedullary haemorrhagic cavernoma with associated cord oedema. Surgery was deferred due to extensive oedema and unclear margins, and conservative care with early intensive neurorehabilitation was initiated. Marked improvement occurred from Modified McCormick grade 5 to grade 3 within weeks; by six months she achieved independent transfers and ambulation with crutches, with persistent bladder dysfunction.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/conservative-management-and-early-intensive-rehabilitation-following-haemorrhage-of-a-thoracic-intramedullary-spinal-cord-cavernoma-a-case-report/443474/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/conservative-management-and-early-intensive-rehabilitation-following-haemorrhage-of-a-thoracic-intramedullary-spinal-cord-cavernoma-a-case-report/443474.png","ImageObject",300,407,{"name":42,"@type":43},"River Wang","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",8,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Why was surgical intervention deferred in this case?","Question",{"text":63,"@type":64},"Surgery was deferred in the acute phase because of the extent of haemorrhage-related oedema and unclear lesion margins, making operative planning uncertain.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What did MRI show in the patient?",{"text":68,"@type":64},"MRI demonstrated a haemorrhagic intramedullary cavernoma at the T12 level with surrounding cord oedema extending from T9 to the conus.",{"name":70,"@type":61,"acceptedAnswer":71},"What functional recovery was reported after early intensive neurorehabilitation?",{"text":72,"@type":64},"The patient improved from Modified McCormick grade 5 to grade 3 within weeks. By six months, she achieved independent transfers and ambulation with crutches, with functional independence in most activities of daily living, though bladder dysfunction persisted.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},443474,1790762254,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":97,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":144,"preview_page_count":4},1099514067438,"https://ap-avatar.wpscdn.com/avatar/100002539ee87300030?x-image-process=image/resize,m_fixed,w_180,h_180&k=1780474512215547542","Review began 11/10/2025  \nReview ended 11/29/2025  \nPublished 12/06/2025  \n© Copyright 2025  \nVenugopal et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98576  \nOpen Access Case Report  \nConservative Management and Early Intensive Rehabilitation Following Haemorrhage of a Thoracic Intramedullary Spinal Cord Cavernoma:  \nA Case Report  \nDharaneswar Venugopal 1 , Bahar G. Yenidunya 1, Eleonora Bradaschia 1  \n1. Rehabilitation Medicine, Orpington Hospital, King 's College Hospital NHS Foundation Trust, London, GBR Corresponding author: Dharaneswar Venugopal, [dharaneasvar@gmail.com](dharaneasvar@gmail.com)  \nAbstract  \nSpinal 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-yearold 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.  \nCategories: Neurology, Physical Medicine & Rehabilitation, Neurosurgery  \nKeywords: cavernous malformation, conservative management, spinal cord cavernoma, spinal cord injury, spinal cord rehabilitation  \nIntroduction  \nSpinal cord cavernous malformations (SCCMs) are rare vascular lesions of the spinal cord, representing approximately 5-12% of all spinal vascular malformations [1] . They consist of clusters of thin-walled capillaries prone to recurrent micro-haemorrhage and gliosis and may present acutely with neurological deterioration. Clinical manifestations range from back pain and sensory disturbance to motor weakness and bowel and bladder dysfunction, depending on the level of the lesion [2] .  \nWhile surgical resection is often considered the definitive treatment, the intramedullary location of these lesions makes surgery technically challenging and carries a significant risk of additional neurological morbidity. The role of conservative management remains less clearly defined, largely because the natural history of SCCMs is poorly understood. As highlighted in the literature, most published series are biased toward surgically treated cases, resulting in limited data on non-operative outcomes and making it difficult to develop robust evidence-based guidance [3] .  \nAn important consideration in conservatively managed cases is that neurological recovery may arise from a combination of mechanisms. Partial spontaneous improvement may occur as haemorrhage and surrounding oedema resolve, while early neurorehabilitation can further enhance functional recovery. Distinguishing the relative contributions of these factors can be challenging, yet documenting such trajectories is essential for clinicians managing patients in whom surgical intervention poses a high risk.  \nWe present the case of a previously healthy young woman with acute neurological decline se","cbCaivXIgZA1LHXN","https://ap.wps.com/l/cbCaivXIgZA1LHXN","pdf",2254787,"English","# Abstract\n# Introduction\n# Case Presentation","[{\"question\":\"Why was surgical intervention deferred in this case?\",\"answer\":\"Surgery was deferred in the acute phase because of the extent of haemorrhage-related oedema and unclear lesion margins, making operative planning uncertain.\"},{\"question\":\"What did MRI show in the patient?\",\"answer\":\"MRI demonstrated a haemorrhagic intramedullary cavernoma at the T12 level with surrounding cord oedema extending from T9 to the conus.\"},{\"question\":\"What functional recovery was reported after early intensive neurorehabilitation?\",\"answer\":\"The patient improved from Modified McCormick grade 5 to grade 3 within weeks. By six months, she achieved independent transfers and ambulation with crutches, with functional independence in most activities of daily living, though bladder dysfunction persisted.\"}]","Conservative Management and Early Intensive Rehabilitation Following Haemorrhage of a Thoracic Intramedullary Spinal Cord Cavernoma - A Case Report | PDF",1790704181,13]