What is a spinal hemangioma? Is it dangerous?

neirokirurgi.lv/en/
Vertebral hemangiomas or haemangiomas (VHs) are a common vascular lesion found within the vertebral body of the thoracic and lumbar spine. These are predominantly benign lesions that are often found incidentally during radiology studies for other indications and can involve one or multiple vertebrae. Vertebral hemangiomas are a common etiology estimated to be found in 10-12% of humans at autopsy. They are benign in nature and frequently asymptomatic. Symptoms, if they do occur, are usually related to large hemangiomas, trauma, the hormonal and hemodynamic changes of pregnancy (causing intra-spinal bleeding), or osseous expansion and extra-osseous extension into surround soft tissues or epidural region of the spinal canal.
Vertebral hemangiomas are observed throughout any age, although most are diagnosed in people within their 50s alongside a higher presence in females with a 1:1.5 male-to-female ratio. They often present in the vertebral body of the thoracic and lumbar spine with potential to extend into the posterior arch. They can involve a single or multiple vertebrae.
Hemangiomas can display typically and atypically. Typical VHs have predominant fat overgrowth that present throughout various scanning techniques differently compared with atypical VHs that have less fat and more vascular content (see diagnosis).
Most hemangiomas present asymptomatically and only found incidentally through MRI, CT, or radiography. However, hemangiomas can become symptomatic in around 1% of cases.
In these rare cases, hemangiomas present active behavior and are known as aggressive or compressive VHs. When symptomatic, they can cause pain and myelopathy by intra-spinal bleeding, bony expansion or extra-osseous extension into surround soft tissue or the posterior neural elements. Highly vascular (cavernous type) hemangiomas can produce neurologic deficits without prominent evidence of spinal cord compression. The deficits in these cases are probably attributable to blood flow disturbances in the spinal cord

[@mujunes]

Brilliant! I appreciate it.

[@BrainandSpineSurgeryRiga]

Thanks a lot for your comment! Mr Janis Slezins, MD, Neurosurgeon

[@MJ-fr9zu]

Very useful video! I had really bad and persistant lower neck pain and upper back pain (19 years old) so I went to the doctor and they did an MRI which showed a hemangioma on the T2 vertebral body with signal intensity ratio of the opposed phase over the in phase is 0.87 on axial view and approx. 0.81 on the sagittal view. The MRI also showed mild degenerative upper to mid-cervical disc disease (with no significant protrusions or canal compromise). I couldn't afford any follow-ups but my pain has been getting worse in the past few months, what should I do? Is it the hemangioma?

[@BrainandSpineSurgeryRiga]

Thanks a lot for your comments. Hemangiomas are very unlikely to cause any symptoms, except very rare cases, therefore just from the statistical point of view its unlikely that yoyr pain is related to hemangioma. Since there are some degenerative changes observed, they are more likely to be cause of symptoms. Constant, intensive physiotherapy undr guidance of physiotherapist is cornerstone of back pain treatment, therefore this seem to be your way.
Best regards,
Mr Janis Slezins, MD, PhD

[@AAAMHHH]

Great video, thank you.
T1 vertebral Hemangioma, left sided weakness, neck pain, back pain & neurological symptoms.
What would you recommend patient do next after this discovery & these accompanying symptom’s?

[@BrainandSpineSurgeryRiga]

Hi, thank you for the comment and question. Majority of hemangiomas are benign and have no symptoms at all, except very rare cases. In your case it would be useful to consult with experienced neurosurgeon, to understand if your symptoms are related to hemangioma or there is another cause. If yes, then there is need to develop comprehensive treament plan.
Best regards,
Mr Janis Slezins, MD, PhD

[@jspychalski7286]

I had a cavernous hemangioma in my cervical spinal cord that paralyzed me from the neck down after a seizure and stroke caused from multiple hemorrhages. Finally had it removed and was able to learn to walk again. I have some residual effects, but I can walk.

[@BrainandSpineSurgeryRiga]

Thanks for your comment. Its extremely rare case that you have experienced. Hopefully you are doing well!

[@joy6097]

Very good video. As per mri report hemangioma seen L1 vertebra. At night there are little bit pain in thigh, calf.
Please tell me is this ok or it is timor?

[@BrainandSpineSurgeryRiga]

Thanks for your comment and question. No hemangioma is not a tumor, however in rare occasions it can produce some pain, but it is not radiating elsewhere, therefore I believe your pain is likely not related to hemangioma. There should be another cause.
Regards,
Janis Slezins, MD, PhD, Neurosurgeon

[@joy6097]

@@BrainandSpineSurgeryRiga Thankyou for your advice.
Actually nerve root has been compressed between L3 and L4 and L5 in lumbar spine.
So there is

[@user-ro6vm2ve2r]

Добрый день а можно будет перевод?у меня есть это заболевание операция прошла в 2017 .

[@BrainandSpineSurgeryRiga]

Спасибо за комментарий и вопрос! На канале есть видео на русском посвяшённый данной тематике.
Доктор Янис Шлезиньш, нейрохирург, ДМН

[@Moxi_Shukrona_Fuzail_Zubayr]

​@@BrainandSpineSurgeryRigaЗдравствуйте в Москве?

[@Abhijit29]

Hi Doc,
My sister is diagnosed with tiny lipo hemangioma in l5 l3 l1 vetebral ....she is only having on and off sciatica problem in interval of 4 months and RLS symptoms.Adding to it her iron level is on lower side . Kindly suggest if she needs to be on treatment.

[@BrainandSpineSurgeryRiga]

Hi,
Thanks for your comment and question. Tiny lipohamangomas are extremely unlikely to cause any symptoms. There should be another cause to explan pain, which is not possible to identify from your comment. General advise would be to engage in physiotherapy to build upa paraspinal muscles.
Best regards,
Janis Slezins, MD, PhD

[@Abhijit29]

@@BrainandSpineSurgeryRiga thanks so much doctor for your valuable response.

[@choneydema3903]

Recently I had a MIR for L spine and says there is hemangioma. I did MIR because it’s been almost 5 to 6 years that I am having a back and leg pain, pain gets on and off. But recently I had a severe back pain especially lower spine area. So I am just concerned whether this symptoms are all because of the hemangioma.
Please doctor advise me on this 🙏🏻

[@BrainandSpineSurgeryRiga]

Hi! Thanks for the comment and question. Hemagioma extremely rare has any clinical relevance and produce any kind of symtoms, therefore statistically its unlikely that it can be cause of your pain, however, without seeing images I am not able to say if you may be exception.

[@bhouriasingh7984]

Hi Doctor
My MRI accidentally show hemangioma on T4 or T11. I had numbness in left arm that’s by I went to mri, rest of mri normal but mri only shows hemangioma. I don’t have any symptoms. After check mri I have started some pain in the back. It can be from anxiety, because I have some health anxiety. Fear of disease.
I waiting for your reply
Thank you

[@BrainandSpineSurgeryRiga]

Hi,
Thanks for the comment and question - hemangiomas are beningn lesions in spine without any clinical significance except very rare cases when hemangioma behaves agressively or is very large. It seems this is not your case. There is no need for follow up as they are not growing (except those very rare cases). Numbness in left arm cannot be related to hemantioma un T4 or T11 as nerves leaving from there do not end up in arm.
Hope this helps,
Regards,
Mr. Janis Slezins, Md, PhD, Neurosurgeon

[@bhouriasingh7984]

@@BrainandSpineSurgeryRiga Thank you doctor. I really appreciate your answer. You have removed my tension. I was very nervous and sad. I appreciate your efforts you give answer to my question.
Thank you

[@_dear.straw.brry_]

Nice explain sirji...
Sir As per my Mri report... I hve l..3 vertebral hemnagioma prolem. Pliz suggest me 🙏🙏🙏🙏🙏
And Dr gave me only some medicine like curecumin n piperine tablets and pregabalin n nortriptyline tblets.

[@BrainandSpineSurgeryRiga]

Thanks for your comment. If your hemangioma is causing problems, you most likely need vertebroplasty surgery, which we are happy to provide. Regards, Janis Slezins, MD, PhD

[@karimelghamry7527]

Hi doctor, I just got my MRI Results
Benign T1 hyperintense foci in T11 and T12 likely represent venous malformations. This is fine

[@BrainandSpineSurgeryRiga]

Hi,
Yes, most likely its fine and these finding do not have any clinical relevance.
Janis Slezins, MD, PhD, Neurosurgeon

[@twodaysworld8023]

Hi dr, my mother age 55, her hemangioma L5 vertebral, He feel leg burn...please give any suggestion.

[@BrainandSpineSurgeryRiga]

Hi, need to look at the scans, as quite often hemangioma is not a cause of leg burn.
Regards,
Janis Slezins, MD, PhD

[@Nawandikajayawardena]

Hi doctor
What is a lipid poor hemongioma?
Thnks doctor

[@BrainandSpineSurgeryRiga]

Thanks for you comment and question.
Lipid poor hemangioma is just a sub type of hemangiomas, but there is no much of a difference between them in practical terms - vast majority of them do not require any treatment and does not have any clinical significance.
Best regards,
Janis Slezins, MD, PhD, Neurosurgeon

[@Nawandikajayawardena]

@@BrainandSpineSurgeryRiga thanks doctor ❤️

[@asiarajouri1725]

Hindi translate

[@BrainandSpineSurgeryRiga]

Unfurtunately I dont know hindi.
Regards, Janis Slezins, MD, PhD, Neurosurgeon

[@fan_pavel_sazhina]

Що, не понятно

[@BrainandSpineSurgeryRiga]

Спасибо за комментарий!
Доктор Янис Шлезиньш, нейрохирург