• Junkoh Yamamoto, Mayu Takahashi, Daisuke Akiba, Yoshiteru Soejima, Yoshiteru Nakano, Yuichi Aoyama, Yukunori Korogi, and Shigeru Nishizawa.
• Department of Neurosurgery, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyusyu 807-8555, Japan. yama9218@med.uoeh-u.ac.jp
• Spine J. 2009 May 1; 9 (5): e10-3.

Background ContextHemangioblastomas in the central nervous system are highly vascular lesions, but have low risk of hemorrhage. In spinal lesions, there are a few rare cases of intramedullary hemorrhages associated with hemangioblastoma, and their prognoses were very severe.PurposeThis is the first case of an intrasyrinx hemorrhage associated with hemangioblastoma in epiconus. We report this rare case and discuss the clinical manifestations of intrasyrinx hemorrhage caused by hemangioblastoma in epiconus.Study DesignA case report.MethodsThis case report presents a 45-year-old woman with intrasyrinx hemorrhage caused by hemangioblastoma in epiconus. The patient presented with a sudden onset of burning bilateral leg pain and rectal/bladder dysfunction, indicating conus medullaris syndrome. Initial magnetic resonance imaging revealed an intramedullary nodular lesion in the epiconus and holocord syringomyelia. However, follow-up magnetic resonance imaging showed intramedullary hemorrhage.ResultsThe patient underwent surgery, and an intrasyrinx hematoma was evacuated and the tumor was completely removed. Histological diagnosis was hemangioblastoma. Three months after surgery, the patient recovered from neurological deficits.ConclusionsWe present this rare case, and emphasize hemangioblastoma as the differential diagnosis in hemorrhagic spinal lesion.

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