Postpartum hemorrhagic vertebral hemangioma with pathological vertebral fracture: A case report highlighting spinal instability as a potential mechanical cofactor.
- 1Department of Neurosurgery, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey.
Abstract
Background
Aggressive vertebral hemangiomas (VHs) rarely cause fracture or epidural hemorrhage. Pregnancy- related hemodynamic changes may promote progression, whereas the role of instability is poorly defined.Case description
A 30-year-old female presented 2-week postpartum with severe mechanical thoracolumbar pain and mild right leg weakness. Imaging showed an aggressive T12 VH with >50% collapse, kyphosis, posterior epidural hemorrhagic extension, and marked canal compromise. The retrospective Spinal Instability Neoplastic Score was 15/18. After preoperative embolization, a T12 and superior L1 laminectomy/decompression was performed, and the hematoma was removed. Gross T11-L1 instability was noted intraoperatively, thus warranting simultaneous T10-L2 fusion plus open T12 cement augmentation. Postoperatively, strength normalized within 1 week, and 2 years later, she remained pain-free and neurologically intact without radiological progression or recurrence.Conclusion
In this postpartum case, pathological collapse and instability accompanied hemorrhagic progression of an aggressive VH. When instability is evident, simultaneous stabilization should be considered along with decompression.
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BibTeX
@article{cerci2026postpartum,
title = {{Postpartum hemorrhagic vertebral hemangioma with pathological vertebral fracture: A case report highlighting spinal instability as a potential mechanical cofactor.}},
author = {Huseyin Mert Cerci and Tufan Ay and Semih Can Çetintaş and Mustafa Onur Ulu},
journal = {Surgical neurology international},
year = {2026},
month = oct,
doi = {10.25259/sni_1167_2026},
url = {https://europepmc.org/article/MED/42974333},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Postpartum hemorrhagic vertebral hemangioma with pathological vertebral fracture: A case report highlighting spinal instability as a potential mechanical cofactor.
AU - Huseyin Mert Cerci
AU - Tufan Ay
AU - Semih Can Çetintaş
AU - Mustafa Onur Ulu
PY - 2026
DA - 2026/10/23
JO - Surgical neurology international
DO - 10.25259/sni_1167_2026
UR - https://europepmc.org/article/MED/42974333
AB - Background Aggressive vertebral hemangiomas (VHs) rarely cause fracture or epidural hemorrhage. Pregnancy- related hemodynamic changes may promote progression, whereas the role of instability is poorly defined.Case description A 30-year-old female presented 2-week postpartum with severe mechanical thoracolumbar pain and mild right leg weakness. Imaging showed an aggressive T12 VH with >50% collapse, kyphosis, posterior epidural hemorrhagic extension, and marked canal compromise. The retrospective Spinal Instability Neoplastic Score was 15/18. After preoperative embolization, a T12 and superior L1 laminectomy/decompression was performed, and the hematoma was removed. Gross T11-L1 instability was noted intraoperatively, thus warranting simultaneous T10-L2 fusion plus open T12 cement augmentation. Postoperatively, strength normalized within 1 week, and 2 years later, she remained pain-free and neurologically intact without radiological progression or recurrence.Conclusion In this postpartum case, pathological collapse and instability accompanied hemorrhagic progression of an aggressive VH. When instability is evident, simultaneous stabilization should be considered along with decompression.
SN - 2229-5097
SN - 2152-7806
ER -