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Case Reports: Rare disease
Combined endovascular and surgical management of a case of Cobb syndrome
  1. Surya Nandan Prasad1,
  2. Bapi Barman2,
  3. Vivek Singh2 and
  4. Kuntal Kanti Das3
  1. 1Radiodiagnosis, All India Institute of Medical Sciences, Patna, Bihar, India
  2. 2Radiodiagnosis, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
  3. 3Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
  1. Correspondence to Dr Vivek Singh; singhvivek79{at}rediffmail.com

Abstract

Cobb syndrome is a rare neurocutaneous disorder characterised by spinal and cutaneous vascular malformations in a metameric distribution. Managing such cases is a challenge for the interventionists and neurosurgeons as the results are often suboptimal. We describe a case of Cobb syndrome in a young male child who presented clinically with acute paraparesis and lower backache. On radiological workup, an intradural perimedullary complex spinal arteriovenous fistula was seen with presence of subarachnoid haemorrhage in the spinal canal and compressive myelopathy. There was a haemangioma in paraspinal muscles and a maculopapular cutaneous lesion in the lower back. He was treated with combined endovascular embolisation and surgical intervention and showed significant clinical improvement on follow-up.

  • hemangioma
  • neuroimaging
  • spinal cord
  • interventional radiology
  • neurosurgery

https://doi.org/10.1136/bcr-2021-246821

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    Footnotes

    • Twitter @BapiBarman_IR

    • Contributors VS and SNP conceived the manuscript. SNP prepared the manuscript. BB and KKD collected the images and also helped in manuscript preparation. SNP and VS edited the manuscript. The final manuscript was read and approved by all the authors.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.