Extensive metameric involvement in Cobb syndrome presenting as compressive myelopathy

Cobb Syndrome, or cutaneomeningospinal angiomatosis, is a rare non-hereditary neurocutaneous disorder characterised by spinal arteriovenous malformations (AVMs) and cutaneous vascular lesions within the same metamere. We present a case of Cobb syndrome manifesting as progressive paraparesis due to dorsal compressive myelopathy. Unlike most reported cases, which primarily involve the thoracic spine, this case exhibited extensive vascular malformations affecting all spinal segments, making it a rare presentation. Diagnosis was established through MRI and angiographic studies, revealing vertebral hemangiomas and an epidural AVM causing spinal cord compression. Surgical decompression was performed, leading to partial neurological recovery. This case highlights the importance of early recognition of cutaneous markers in diagnosing neurocutaneous syndromes and underscores the need for prompt neurosurgical intervention to prevent irreversible neurological deficits.