eMedicine Specialties > Dermatology > Diseases of the Vessels

Cobb Syndrome: Follow-up

Author: Christopher Norwood, MD, MS, Assistant Clinical Professor, Department of Dermatology, University of Connecticut Health Center
Coauthor(s): Stephen J Krivda, MD, Assistant Professor of Dermatology, Uniformed Services University of the Health Sciences; Chief of the Integrated Department of Dermatology, Chief of Dermatology Service, Director of Dermatopathology, Staff Dermatopathologist, Walter Reed Army Medical Center; Head, Department of Dermatology, Staff Dermatologist and Dermatopathologist, National Naval Medical
Contributor Information and Disclosures

Updated: Dec 12, 2008

Follow-up

Complications

A possible complication if treatment is delayed is Foix-Alajouanine disease4 or subacute necrotic myelopathy due to thrombosis in the spinal angioma.

Prognosis

The prognosis was grim with paralysis inevitable and death from infection likely a century ago. Current intervention provides some hope for minimizing permanent neurological damage. The key is early diagnosis.

Miscellaneous

Medicolegal Pitfalls

In the past, patients were initially diagnosed with atypical poliomyelitis. Since early decompression can minimize symptoms, correct diagnosis is key. Patients with lower extremity weakness or pain should have a thorough skin examination and be examined with the proper imaging modalities promptly.

 


More on Cobb Syndrome

Overview: Cobb Syndrome
Differential Diagnoses & Workup: Cobb Syndrome
Treatment & Medication: Cobb Syndrome
Follow-up: Cobb Syndrome
Multimedia: Cobb Syndrome
References
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References

  1. Cobb S. Haemangioma of the spinal cord associated with skin naevi of the same metamere. Annals Surgery. 1915;62:641-9.

  2. Clinton TS, Cooke LM, Graham BS. Cobb syndrome associated with a verrucous (angiokeratomalike) vascular malformation. Cutis. Apr 2003;71(4):283-7. [Medline].

  3. Shim JH, Lee DW, Cho BK. A case of Cobb syndrome associated with lymphangioma circumscriptum. Dermatology. 1996;193(1):45-7. [Medline].

  4. Wirth FP, Post KD, Di Chiro G. Foix-Alajouanine disease. Spontaneous thrombosis of a spinal cord arteriovenous malformation: a case report. Neurology. 1970;20:1114-18.

  5. Krings T, Geibprasert S, Luo CB, Bhattacharya JJ, Alvarez H, Lasjaunias P. Segmental Neurovascular syndromes in children. Neuroimaging Clin N Am. May 2007;17:245-58. [Medline].

  6. Miyatake S, Kikuchi H, Koide T, Yamagata S, Nagata I, Minami S, et al. Cobb's syndrome and its treatment with embolization. Case report. J Neurosurg. Mar 1990;72(3):497-9. [Medline].

  7. Soeda A, Sakai N, Iihara K, Nagata I. Cobb syndrome in an infant: treatment with endovascular embolization and corticosteroid therapy: case report. Neurosurgery. Mar 2003;52(3):711-5; discussion 714-5. [Medline].

  8. Aminoff MJ, Logue V. Clinical features of spinal vascular malformations. Brain. Mar 1974;97(1):197-210. [Medline].

  9. Aminoff MJ, Logue V. The prognosis of patients with spinal vascular malformations. Brain. Mar 1974;97(1):211-8. [Medline].

  10. Brant AJ, James HE, Tung H. Cutaneomeningospinal angiomatosis (Cobb syndrome) with tethered cord. Pediatr Neurosurg. Feb 1999;30(2):93-5. [Medline].

  11. Doppman JL, Wirth FP Jr, Di Chiro G, Ommaya AK. Value of cutaneous angiomas in the arteriographic localization of spinal-cord arteriovenous malformations. N Engl J Med. Dec 25 1969;281(26):1440-4. [Medline].

  12. Jessen RT, Thompson S, Smith EB. Cobb syndrome. Arch Dermatol. Nov 1977;113(11):1587-90. [Medline].

  13. Kaplan P, Hollenberg RD, Fraser FC. A spinal arteriovenous malformation with hereditary cutaneous hemangiomas. Am J Dis Child. Dec 1976;130(12):1329-31. [Medline].

  14. Karshner R, Rand C, Reeves D. Epidural hemangioma associated with hemangioma of the vertebrae. Report of a case. Arch Surgery. 1939;39:942-51.

  15. Laredo JD, Reizine D, Bard M, Merland JJ. Vertebral hemangiomas: radiologic evaluation. Radiology. Oct 1986;161(1):183-9. [Medline].

  16. Mercer RD, Rothner AD, Cook SA, Alfidi RJ. The Cobb syndrome: association with hereditary cutaneous hemangiomas. Cleve Clin Q. 1978;45(2):237-40. [Medline].

  17. Wakabayashi Y, Isono M, Shimomura T, Tajima A, Terashi H, Asada Y, et al. Neurocutaneous vascular hamartomas mimicking Cobb syndrome. Case report. J Neurosurg. Jul 2000;93(1 Suppl):133-6. [Medline].

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Further Reading

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Keywords

cutaneomeningospinal angiomatosis

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Contributor Information and Disclosures

Author

Christopher Norwood, MD, MS, Assistant Clinical Professor, Department of Dermatology, University of Connecticut Health Center
Christopher Norwood, MD, MS is a member of the following medical societies: American Academy of Dermatology, American Society for Dermatologic Surgery, and American Society for Laser Medicine and Surgery
Disclosure: Nothing to disclose.

Coauthor(s)

Stephen J Krivda, MD, Assistant Professor of Dermatology, Uniformed Services University of the Health Sciences; Chief of the Integrated Department of Dermatology, Chief of Dermatology Service, Director of Dermatopathology, Staff Dermatopathologist, Walter Reed Army Medical Center; Head, Department of Dermatology, Staff Dermatologist and Dermatopathologist, National Naval Medical
Stephen J Krivda, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, Association of Military Dermatologists, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Medical Editor

Abby S Van Voorhees, MD, Assistant Professor, Director of Psoriasis Services and Phototherapy Units, Department of Dermatology, University of Pennsylvania School of Medicine, Hospital of the University of Pennsylvania
Abby S Van Voorhees, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, National Psoriasis Foundation, Phi Beta Kappa, Sigma Xi, and Women's Dermatologic Society
Disclosure: Amgen Honoraria Consulting; Abbott Honoraria Consulting; Genentech Honoraria Consulting; Incyte Grant/research funds Other; Warner Chilcott Honoraria Consulting; Merck Salary Management position; Abbott  Speaking and teaching

Pharmacy Editor

David F Butler, MD, Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic
David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Managing Editor

Rosalie Elenitsas, MD, Herman Beerman Associate Professor of Dermatology, University of Pennsylvania School of Medicine; Director, Penn Cutaneous Pathology Services, Department of Dermatology, University of Pennsylvania Health System
Rosalie Elenitsas, MD is a member of the following medical societies: American Academy of Dermatology and American Society of Dermatopathology
Disclosure: Nothing to disclose.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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