搜索结果：Pain reports

This study describes the effect of nasal neurostimulation in five cases of postherpetic neuralgia (PHN) after herpes zoster ophthalmicus. This retrospective case series included five symptomatic patients with PHN who were receiving conventional pain therapy and underwent a single session of nasal neurostimulation for additional oculofacial pain relief. Neurostimulation was performed either through intranasal or extranasal application. Pain intensity was assessed before and after treatment using the visual analog scale (VAS; 0-10). Three patients received intranasal and two received extranasal neurostimulation therapy. Despite maximum tolerated systemic and ocular pain treatments, mean baseline oculofacial pain VAS scores ranged between 3 and 4 of 10 in the intranasal group and 2 and 3 of 10 in the extranasal group. All patients reported complete pain relief following neurostimulation. The duration of pain relief ranged from four to eight hours after a single treatment session. Nasal neurostimulation may represent a promising adjuvant therapy for patients with PHN who are receiving conventional pain treatment and are seeking additional oculofacial pain relief.

Sigmoid volvulus (SV) is a closed‑loop large bowel obstruction that is exceedingly uncommon in children and adolescents.Early diagnosis is essential, as progressive torsion of a redundant sigmoid colon around its mesentery leads to venous congestion, arterial compromise, and eventual bowel necrosis and perforation if untreated.Pediatric SV presents with crampy abdominal pain, distension, vomiting, and obstipation; however, low back pain has not previously been described as a primary presenting symptom. This report describes the case of a 17‑year‑old boy who presented with a chief complaint of severe bilateral lower back and moderate bilateral hip and flank pain, as well as a previous bout of associated mild suprapubic discomfort that subsided prior to arrival. He was subsequently diagnosed with SV on computed tomography and was successfully managed with emergent endoscopic detorsion followed by elective robotic sigmoid resection.

The meniscus is essential for knee joint biomechanics, contributing to load distribution and stability. Variations such as the anterior medial meniscofemoral ligament (AMMFL) originating from the anterior horn of the medial meniscus (AHMM) are rare but significant. These variations may predispose individuals to medial meniscus injuries and knee dysfunction, though their biomechanical implications remain unclear. The AMMFL disrupts normal anchorage of the AHMM to the tibial plateau, increasing meniscal mobility and potentially altering load transmission and predisposing to degeneration or tears. Case 1: A 49-year-old woman presented with left knee pain without trauma. MRI identified a medial meniscus posterior root tear (MMPRT). During arthroscopy, an AMMFL was discovered connecting the AHMM to the intercondylar notch. The MMPRT was repaired with transtibial suture fixation, while the AMMFL was retained due to its non-impinging nature. Quantitative MRI revealed an AMMFL measuring 3 mm × 2.1 mm with low signal intensity. At 10-month follow-up, the patient reported significant pain relief and restored knee function (e.g., resolution of squatting difficulty, KOOS score improved from 48 to 84). Case 2: A 58-year-old woman with chronic right knee pain and osteoarthritis underwent unicompartmental knee arthroplasty. During surgery, a free AHMM attached to the intercondylar notch via a tendon-like AMMFL was observed and excised. Intraoperative measurement showed a 27 mm ligament-like structure, confirmed histologically as dense parallel collagen bundles without fibrocartilage. At 8-month follow-up, the patient walked freely; full weight-bearing achieved by 4 weeks (Oxford Knee Score improved from 19 to 39). Treatment differed based on impingement status and degenerative context: retention after root repair in Case 1 versus excision during UKA in Case 2. Both cases revealed below-average medial posterior tibial slopes (MPTS, case 1 is 4.49° and case 2 is 2.17°), questioning the biomechanical role of AMMFL in MMPRT development. AMMFL is a rare anatomical variant with unclear biomechanical roles. The abnormal attachment of the AMMFL could potentially alter normal meniscal kinematics and load distribution. This anatomical configuration may be associated with posterior root tears even in knees with a low tibial slope, suggesting a possible biomechanical vulnerability that warrants further investigation. This potential biomechanical vulnerability-inferred from the anatomy and the presentation of MMPRT with low MPTS-highlights the importance of meticulously evaluating the posterior horn and root attachment in patients with an AMMFL on MRI. Although a causal link remains unproven, the association suggests these patients may be prone to tears despite the absence of other traditional risk factors. Awareness of this variant is crucial for accurate imaging diagnosis and arthroscopic evaluation, as it may identify knees at biomechanical risk for posterior root tears, warranting further investigation.

Myofascial pelvic pain syndrome (MPPS) is a form of chronic pelvic pain (CPP) and pelvic floor dysfunction (PFD), significantly affecting women's physical and mental health. To date, high-quality evidence regarding the efficacy of acupuncture for treating MPPS is lacking. This dual-center randomized controlled trial aims to investigate whether acupuncture is effective for MPPS. A dual-center, parallel, randomized, controlled trial will recruit 180 participants diagnosed with MPPS, who will be randomly allocated (1:1) via computer-generated block randomization to receive either acupuncture treatment or combined electromyographic biofeedback with neuromuscular electrical stimulation (EMG-BF+NMES) for 3 weeks. Primary outcomes include pain intensity (Visual Analog Scale, VAS), myofascial tenderness, pelvic floor muscle function (Modified Oxford Scale), and ultrasound-guided VAS of myofascial trigger points. Secondary outcomes encompass pelvic floor neuromuscular activity (surface electromyography using the Glazer Protocol), Pelvic Floor Distress Inventory-Short Form 20 (PFDI-20), Pelvic Floor Impact Questionnaire-7 (PFIQ-7), Patient Assessment of Constipation Symptoms (PAC-SYM), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and the Pittsburgh Sleep Quality Index (PSQI). Assessments are scheduled at baseline (T0), immediately after the initial intervention (T1), at 1, 2, 3 weeks post-intervention (T2-T4), and at 3-month post-treatment follow-up (T5). Adverse events will be collected and recorded throughout the treatment period. This trial will evaluate the efficacy and safety of acupuncture for MPPS, compare its therapeutic effects with EMG-BF+NMES, and provide evidence to support the clinical application of acupuncture. This study protocol was reviewed and approved by the Ethics Committee of Hangzhou Hospital of Traditional Chinese Medicine (Approval No. 2025LL003). Findings will be disseminated through peer-reviewed publications and academic conferences. ITMCTR2025000458.

AbstractMorning Report is a time-honored tradition in which physicians-in-training present cases to their colleagues and clinical experts to collaboratively examine an interesting patient presentation. The Morning Report section seeks to carry on this tradition by presenting a patient's chief concern and story, inviting the reader to develop a differential diagnosis and discover the diagnosis alongside the authors of the case. This report examines the story of a 53-year-old woman who sought evaluation for pain in both ears, hearing loss, and facial weakness. Using questions, physical examination, and testing, an illness script for the presentation emerges. As the clinical course progresses, the differential is refined until a diagnosis is made.

Non-typhoidal Salmonella (NTS) is a rare but life-threatening cause of infectious aortitis and mycotic aneurysm formation, predominantly affecting immunocompromised patients and those with pre-existing vascular pathology or prosthetic hardware. Diagnosis is frequently delayed due to its non-specific clinical presentation and the poor sensitivity of conventional blood cultures. A 73-year-old immunocompromised woman with a history of penetrating aortic ulcer and prior endovascular aortic stent graft placement presented with progressive abdominal pain and para-aortic soft tissue thickening encasing the infrarenal aorta. Blood cultures were negative; however, CT-guided peri-aortic tissue aspiration and metagenomic next-generation sequencing (mNGS; Karius test) identified Salmonella enterica serovar Enteritidis susceptible to ampicillin, ceftriaxone, levofloxacin, nalidixic acid, and trimethoprim/sulfamethoxazole. The most probable infection source was the patient's prolonged daily consumption of unpasteurized eggs from backyard chickens. She was treated with intravenous (IV) ceftriaxone for 30 days followed by 18 months of oral cephalexin suppression, with significant radiographic improvement at three-month follow-up. Surgical intervention was deferred given her high operative risk from metastatic malignancy and multiple comorbidities. This case is notable for its documentation of culture-negative NTS aortitis complicating an endovascular stent graft, in which mNGS was essential for pathogen identification. It further highlights the importance of eliciting detailed dietary exposure history in high-risk patients, the novel diagnostic challenge posed by concurrent autoimmune disease mimicking non-infectious vasculitis, and the feasibility of antibiotic-only management in carefully selected surgical non-candidates.

Transvaginal mesh, used to treat Pelvic Organ Prolapse and Stress Urinary Incontinence, has caused substantial injury to a growing number of women. The impact of mesh injury is far-reaching, significantly disrupting women's lives. Whilst there is a growing body of literature examining the impacts, there is little research that specifically aims to understand the sexual and relational implications of mesh injury. This study aimed to systematically review evidence regarding the impacts of mesh injury reported by women in relation to sexual and relational functioning. A systematic search of five databases (CINAHL, MEDLINE, PubMed, PsycINFO, and ProQuest Dissertations and Theses) and a grey literature search was conducted in April 2026. Studies and inquiries reporting data about women's experiences of mesh injury where sexual and relational impacts were reported were included. The quality of each study was assessed using the qualitative CASP checklist. The data was thematically synthesised. A total of nine reports were included, comprising of six published studies, one unpublished Doctoral thesis, and two government inquiries. Sample sizes were varied, with individual study sample sizes ranging from 7-84, and a secondary analysis of 399 accounts from one study. Participants included in government inquiries ranged between 517 and 555. A conservative total of 1483 participants is represented, reflecting the heterogeneity of the evidence base and limitations in the reporting of inquiry data. Of the nine included reports, eight were rated high quality with one rated as moderate. Seven overlapping themes were developed from the data: 1) Sexual functioning: changes due to pain, 2) Changes to sexuality, 3) Relational activity: changes due to pain, 4) Changes to relationship satisfaction, 5) Identity: changing sense of self navigating life with mesh injury, 6) Changes in relational roles and a seventh central theme of disrupted embodied sexual-relational self. Women with mesh injury experience significant sexual and relational disruption as a result of chronic pain, contributing to psychological distress. Psychological flexibility may be a protective mechanism for relational distress. Further research that seeks to understand these impacts is needed, which may inform the development of appropriate psychological interventions. PROSPERO ID: CRD420251077730.

Accessory carpal bones around the scaphoid are uncommon anatomical variants that may mimic fractures, non-unions, or other pathological entities on wrist imaging. Despite more than a century of published reports, the literature remains limited by inconsistent terminology, unclear anatomical definitions, and variable reporting quality. This review aimed to synthesize the available evidence on accessory bones around the scaphoid and to clarify their prevalence, anatomical characteristics, imaging features, clinical presentation, and management. We performed a combined systematic review, prevalence meta-analysis, and scoping review. PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar were searched without date or language restrictions. For the meta-analytic component, original prevalence studies were included; for the scoping component, case reports and case series were additionally evaluated to map anatomy, terminology, imaging findings, symptoms, and treatment. Eleven studies comprising 27,681 examined limbs were included in the prevalence synthesis, and 60 case reports describing 71 subjects were included in the scoping review. Reported accessory bones around the scaphoid included os centrale carpi, os scaphoideum bipartitum, os radiale externum, os radiostyloideum, os epitrapezium, os scaphocapitatum anterius, and the poorly defined os parascaphoideum. Pooled prevalence estimates for individual entities were uniformly low, generally below 0.1%, with substantial heterogeneity and important methodological limitations related to inconsistent terminology and unclear anatomical criteria. Case reports showed that these variants are usually incidental but may occasionally present with pain, restricted motion, edema, fracture, or diagnostic confusion after trauma. Across the literature, reporting quality was generally low, and anatomical definitions were often insufficient. Accessory bones around the scaphoid are rare and remain poorly characterized in the literature. A standardized anatomical definition and diagnostic criteria based on standardized imaging are needed to improve future research.

Excessive distraction (ED) during anterior cervical spine surgeries may improve cervical alignment but higher the risk of postoperative complications. To date, no comprehensive reviews has evaluated the overall impacts of ED across anterior cervical spine surgeries. This study aims to evaluate the impact of excessive distraction (ED) on clinical and radiological outcomes during anterior cervical spine surgeries. A systematic search (PubMed, Europe PMC, Embase, Scopus, Google Scholar; up to March 2025) identified studies reporting distraction and postoperative outcomes after ACDF or CDR. Studies without clinical/radiological outcomes, incomplete statistical reporting, case reports or animal and cadaveric studies were excluded. Data were stratified into early (<&#x2009;6 months) and late (&#x2265;&#x2009;6 months) post-operative. Meta-analyses were conducted using Cochrane Review Manager 5.4.1 and R-Studio 4.5.2. A total of 19 cohort studies encompassing of 1877 patients were included. Excessive distraction was associated with greater post operative neck pain (nVAS: early SMD 0.46; late SMD 0.4, both p&#x2009;<&#x2009;0.00001), arm pain (aVAS: early SMD 0.28, p&#x2009;=&#x2009;0.007; late SMD 0.36, p&#x2009;=&#x2009;0.004), and disability (NDI: early SMD 0.28, p&#x2009;=&#x2009;0.002; late SMD 0.46, p&#x2009;<&#x2009;0.00001). No significant differences were found in mJOA or SF-36 scores. Radiologically, ED improved cervical lordosis (C2-C7 Cobb angle: SMD 0.27, p&#x2009;=&#x2009;0.0005) and range of motion (SMD 0.62, p&#x2009;<&#x2009;0.00001). However, ED increases risks of adjacent segment degeneration (ASD) (RR 2.98, p&#x2009;<&#x2009;0.00001), cage subsidence (RR 1.63, p&#x2009;<&#x2009;0.00001) and heterotopic ossification (HO) (RR 1.99, p&#x2009;=&#x2009;0.009). Excessive distraction in anterior cervical spine surgeries improves cervical alignment and mobility but worsens pain, disability, and long-term complications. Optimal, not maximal distraction should be targeted to balance alignment benefits with functional outcomes and mechanical safety.

The objective of this study was to estimate the prevalence of primary dysmenorrhea and associated symptoms among adolescent girls. This school based cross-sectional study was conducted among 5,000 adolescent girls from 55 randomly selected schools. The data were collected by using Dysmenorrhea questionnaire and numerical pain rating scale along with demographic details. The data were analysed using Jamovi -open statistical software version 2.6.44. A bivariate logistic regression model was computed and variables whose p-value was <&#x2009;0.05 in the bivariate logistic regression analysis were further included in the multiple logistic regression analysis. The prevalence of primary dysmenorrhea was found among 3441 (68.82%), 1686 (49.01%) had mild pain, 1496 (43.4%) had moderate pain, 259 (7.52%) had severe pain. Multiple logistic regression revealed, factors such as mothers with and without dysmenorrhea, having menstruation more than once in a month, menstruation once in two months, lethargy and tiredness day before menstruation, lethargy and tiredness day after, irritability on the day before menstruation, and constipation on the first day of menstruation were associated with primary dysmenorrhea. The prevalence of dysmenorrhea is high among adolescent girls, which highlights the need for early diagnosis and development and implementation of interventions to promote the school health and wellbeing.

We report the case of a 48-year-old woman admitted with acute right flank pain and circulatory collapse. The initial diagnosis was right iliac vein thrombosis and a large retroperitoneal hematoma. Emergency surgery at a local hospital evacuated the hematoma and repaired the right external iliac vein. Postoperatively, she developed severe right leg swelling and pain, and limb-threatening ischemia with extensive right lower limb deep vein thrombosis. After transfer to our center, she underwent inferior vena cava filter placement and emergency thrombectomy. Our initial experience in approaching patients with deep vein thrombosis, abdominal pain, and shock considers spontaneous iliac vein rupture for timely intervention.

Rectus sheath hematoma is an uncommon but important cause of acute abdominal pain that may closely mimic intra-abdominal surgical emergencies, resulting in diagnostic uncertainty and potential delays in management. We report the case of a 64-year-old woman receiving warfarin therapy for chronic atrial fibrillation who presented with sudden-onset severe lower abdominal pain associated with abdominal distension and signs suggestive of an acute abdomen. Clinical evaluation revealed localized abdominal wall tenderness, a palpable infraumbilical mass, anemia, and supratherapeutic anticoagulation. Contrast-enhanced computed tomography (CT) demonstrated a large left-sided rectus sheath hematoma extending below the arcuate line into the prevesical space, causing significant mass effect without evidence of active extravasation. The patient was managed successfully with conservative treatment, including discontinuation of anticoagulation, reversal of coagulopathy, blood transfusion, analgesia, and close hemodynamic monitoring, resulting in progressive clinical recovery and significant interval resolution on follow-up imaging. This case highlights the importance of considering rectus sheath hematoma in the differential diagnosis of acute abdomen, particularly in elderly anticoagulated patients or those with recent episodes of increased intra-abdominal pressure. Prompt recognition through careful clinical assessment and early cross-sectional imaging is essential to avoid unnecessary surgical intervention and to facilitate appropriate management.

Scapular winging is an uncommon but clinically important sign that is often initially attributed to local shoulder pathology or isolated peripheral nerve injury. We report two patients with exertional scapular winging caused by different neurological disorders that are relevant to orthopaedic and surgical practice. The first patient presented with shoulder pain, weakness, sensory disturbance, and a reduced biceps reflex. Electrophysiology demonstrated a C6 radicular syndrome, and cervical magnetic resonance imaging revealed syringomyelia at the C6 level. The second patient developed acute nocturnal shoulder pain followed by persistent weakness and scapular winging. Electrophysiology and nerve ultrasound showed a long thoracic nerve lesion consistent with neuralgic amyotrophy. Both patients were treated conservatively. Pain improved, but scapular winging persisted. These cases show that scapular winging is a clinical sign with a broad differential diagnosis and that structured neurological assessment is essential to avoid misdiagnosis and inappropriate local treatment.

This study aimed to systematically summarize and pool the available evidence on the risk of incident hypertension associated with calcitonin gene-related peptide (CGRP)-targeted therapies. CGRP-targeted therapies have emerged as effective preventive treatments for migraine; however, concerns have been raised regarding their potential hypertensive effects. Prior studies have been limited by small sample sizes, inconsistent definitions of hypertension, and incomplete trial inclusion. We systematically searched MEDLINE, Embase, and ClinicalTrials.gov up to September 25, 2024. We included randomized controlled trials comparing CGRP-targeted therapies with placebo or another intervention arm in adult patients with migraine. The primary outcome was incident hypertension as defined by each individual study. Two reviewers independently assessed risk of bias using the Cochrane Risk of Bias 2 tool and rated the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach. Eight publications or trial reports, comprising 19 underlying randomized controlled trials, were included. The pooled relative risk (RR) for hypertension with CGRP-targeted therapies versus control was 0.91 (95% confidence interval [CI] 0.58-1.43; I&#xb2;&#x2009;=&#x2009;0.0%), indicating no statistically significant increased risk. The certainty of evidence for this outcome was rated as very low. Erenumab showed no significant increase in risk (RR 0.71, 95% CI 0.30-1.70), whereas galcanezumab also showed no statistically significant association (RR 1.14, 95% CI 0.54-2.39). CGRP-targeted therapies were not associated with a statistically significant increase in hypertension risk in patients with migraine, particularly among relatively healthy populations enrolled in short-term randomized controlled trials. However, the certainty of evidence was very low, and possible variation across agents warrants further study. Longer term comparative studies and real-world observational studies with standardized blood pressure monitoring are needed to confirm these findings and better define hypertension risk in higher risk patient subgroups. Migraine treatments that block calcitonin gene&#x2010;related peptide (substances that help transmit pain signals in the body) are widely used, but there are concerns that these drugs might increase blood pressure. We reviewed and combined results from randomized clinical trials to evaluate whether calcitonin gene&#x2010;related peptide&#x2010;targeted therapies increase the risk of developing high blood pressure in people with migraine. Overall, these treatments were not linked to a higher risk of developing high blood pressure in clinical trials, although longer studies and real&#x2010;world data are needed to better understand blood pressure effects in patients who are already at higher risk for heart disease.

Diabetic myonecrosis, also referred to as diabetic muscle infarction, is an uncommon complication of uncontrolled diabetes mellitus. This diagnosis typically occurs in patients who have chronic, poorly controlled diabetes; patients often experience additional diabetic complications. The presentation of diabetic myonecrosis involves an acute onset of swelling and pain in the affected area, typically involving a unilateral lower extremity. Diagnosis is often delayed due to the rarity of the condition, along with the need for advanced diagnostic testing such as MRI or muscle biopsy for confirmation. This case report describes a patient with a history of poorly controlled type 2 diabetes who experienced persistent left thigh pain and swelling that was ultimately diagnosed as diabetic myonecrosis, highlighting the importance of recognizing these symptoms.

Ureteral endometriosis is a rare form of deep infiltrating endometriosis that may lead to silent ureteral obstruction and progressive renal injury. Early diagnosis remains challenging because symptoms are often nonspecific. A 41-year-old nulliparous woman presented with lower abdominal pain radiating to the rectum and thigh. Pelvic examination revealed an immobile posterior cervical mass. Transvaginal ultrasound demonstrated a deep infiltrating endometriosis nodule associated with hydroureter and grade IV hydronephrosis, which was confirmed by magnetic resonance imaging. Surgical management was recommended; however, the patient declined surgery and opted for conservative treatment. She received monthly leuprolide acetate injections for three months. Follow-up evaluation showed reduction in lesion size and improvement in pain symptoms. Ureteral endometriosis should be considered in reproductive-age women with unexplained hydroureteronephrosis. Hormonal therapy may provide temporary symptom control in patients refusing surgery, although careful follow-up is required because of the risk of ongoing renal damage.

Lyme disease is a spirochete infection acquired after inoculation of Borrelia burgdorferi with the bite of an Ixodes tick, commonly encountered in the Northeastern United States, usually characterized by erythema migrans, arthritis, and meningitis. Bannwarth syndrome is an uncommon manifestation of Lyme neuroborreliosis (LNB) in the United States. It can present with various clinical features, which often make the diagnostic process challenging. In our case, the subacute onset of flaccid leg weakness with diminished deep tendon reflexes and facial weakness mimicked Guillain-Barr&#xe9; syndrome (GBS). Physicians need to be aware of the rare neurological manifestations of Bannwarth syndrome, especially in non-endemic areas such as Texas. Here we present a rare case of Lyme neuroborreliosis (LNB) manifesting as a painful meningoradiculitis (Bannwarth syndrome) with radicular pain, paresis, and cranial nerve involvement in Texas.

Conservative treatment of condylar fractures requires the use of occlusal splints. However, limited mouth opening, pain, and tooth damage often prevent timely impression taking, which hinders the fabrication of the occlusal splints. Therefore, there is an urgent need for a convenient and new method. The objective of this study is to evaluate the clinical outcomes and feasibility of innovative 3D-printed occlusal splints for the conservative treatment of condylar fractures. This was a retrospective observational case series study aimed to investigate the clinical outcomes of 3D-printed occlusal splints in the conservative treatment of condylar fractures. The patients were divided into pediatric, young adult, and adult groups according to age. The 3D-printed occlusal splint was secured to the maxilla for 2&#xa0;months. Patients were instructed to perform mouth-opening exercises daily. Mouth opening was recorded before treatment and at the 3-month follow-up. Data were statistically analyzed. After 3&#xa0;months of follow-up, no patients reported persistent pain, with mouth-opening and masticatory functions recovered. The postoperative mouth opening of all three groups was significantly greater compared with preoperative values, and the difference was statistically significant (P&#x2009;<&#x2009;0.05). All groups showed increased mouth opening. Regarding deviation of the mandible during mouth opening, the adolescent group showed significant improvement postoperatively (P&#x2009;<&#x2009;0.05), whereas no statistically significant difference was observed in the pediatric group and the adult group. The use of a 3D-printed occlusal splint combined with mouth-opening exercises is a feasible approach for the conservative treatment of condylar fractures.

Sacral epidural cavernous hemangioma involving the intervertebral foramen is exceptionally rare and may closely mimic more common benign nerve sheath tumors on magnetic resonance imaging. We report the case of a woman in her mid-50s who presented with a 1-month history of nocturnal left lower-extremity pain and mild weakness. Contrast-enhanced lumbar magnetic resonance imaging revealed a strongly enhancing nodular lesion in the left S2 foraminal region, and schwannoma was considered preoperatively. The patient underwent microsurgical resection through a posterior midline approach. Intraoperatively, the lesion was dark red, soft, and hypervascular, raising suspicion for a vascular malformation rather than schwannoma. Frozen-section analysis suggested hemangioma, and postoperative histopathology confirmed cavernous hemangioma. The patient experienced marked postoperative relief of radicular pain, and follow-up analysis indicated complete symptom resolution without radiological evidence of residual lesion. This case emphasizes that cavernous hemangioma should be included in the differential diagnosis of sacral foraminal masses. Purely epidural cavernous hemangiomas centered in the sacral foramen are particularly rare and frequently misdiagnosed preoperatively as schwannoma; thus, careful preoperative planning, anticipation of intraoperative hypervascularity, and frozen-section histology may help guide safe resection.