Acute bleeding of a cavernous malformation of the conus medullaris

A 29-year old arabian man was admitted to the hospital with a progressive sensory loss to light touch, pin prick and vibration of the right and in a lesser extent of the left leg without any association to a particular dermatome. He additionally presented with paraesthesias in both legs, unsteady gait and incipient bladder- and bowl incontinence starting approximately one week prior to admission. Examination of reflexes revealed a diminished achilles tendon reflex in combination with a hyperactive patellar tendon reflex bilaterally. Cerebral spinal fluid (CSF) analysis showed 8 cells/µl, 39mg/dl protein, and 64m…