Ruptured Spinal Arteriovenous Malformation

2019 ◽  
pp. 287-296
Author(s):  
Brandon D. Liebelt ◽  
Michaela H. Lee ◽  
Peter Nakaji ◽  
Robert F. Spetzler
Keyword(s):  
Spinal Cord ◽  
Neurological Deficit ◽  
Arteriovenous Malformations ◽  
Abrupt Onset ◽  
Sudden Onset ◽  
Spinal Arteriovenous Malformation ◽  
History Of ◽  
Severe Back Pain ◽  
Spinal Arteriovenous Malformations ◽  
Microsurgical Resection

Abstract: Ruptured spinal arteriovenous malformations are a rare cause of spinal cord injury. They should be considered especially in the differential diagnosis of younger patients with sudden onset of both severe back pain and neurological deficit. They may present with abrupt onset of hemorrhage, spinal edema and progressive myelopathy, and sudden thrombosis. They may occur in any part of the spinal cord anatomically. The pathophysiology and natural history of these lesions are poorly understood. When feasible, microsurgical resection is the most effective treatment for prevention of further hemorrhage or neurological deficit. In distinction to cerebral arteriovenous malformations, spinal cord malformations can often be treated effectively by pruning the extramedullary vasculature without removing the entire lesion.

scholarly journals Spinal arteriovenous malformation in a pediatric patient with a history of congenital syphilis: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mia J. Bertoli ◽  
Kruti Parikh ◽  
David Klyde ◽  
Catherine A. Mazzola ◽  
Shridevi Pandya Shah
Keyword(s):  
Spinal Cord ◽  
Arteriovenous Malformation ◽  
Evoked Potentials ◽  
Arteriovenous Malformations ◽  
Congenital Syphilis ◽  
Lower Extremities ◽  
Angiography Suite ◽  
Arterial Bleeding ◽  
History Of ◽  
Spinal Arteriovenous Malformations

Abstract Background Spinal arteriovenous malformations in children are extremely rare and pose great risk for intraoperative hemorrhage. Congenital syphilis sometimes presents with vascular symptoms, however, there is little published on patients with a history of congenital syphilis presenting with spinal arteriovenous malformations. Case presentation A 15-month-old female with a history of congenital syphilis presented with urinary retention, fever, and subacute onset of paraplegia. MRI showed a lesion at T8-L1, angiogram was performed which confirmed the presence of a complex type IVc arteriovenous malformation and fistula from Artery of Adamkiewicz at L1-L2. It also showed peri medullary dilated veins and a pseudoaneurysm that compressed the spinal cord at T8-T10. Somatosensory evoked potentials and motor-evoked potentials were not recordable on the bilateral lower extremities prior to surgery. Once the patient was optimized for surgery, osteoplastic laminotomies from T6-T12 were performed. The dura was opened and the intradural, intramesenchymal hematoma was evacuated. There were two episodes of brisk arterial bleeding with hypotension during resection of the hematoma. The patient was taken to the angiography suite from the OR to successfully coil the large aneurysm. Intraoperative spinal cord monitoring remained undetectable in the bilateral lower extremities. The patient’s paraplegia remained unchanged from preoperative presentation. Conclusion Congenital syphilis may present with vascular changes that might impact surgical approaches and treatment outcomes in patients with spinal arteriovenous malformations. Preparation for massive transfusion and intraoperative monitoring are imperative in ensuring a safe perioperative experience.

Ruptured Conus Medullaris Arteriovenous Malformation

2019 ◽  
pp. 297-306
Author(s):  
Michaela H. Lee ◽  
Brandon D. Liebelt ◽  
Peter Nakaji ◽  
Robert F. Spetzler
Keyword(s):  
Spinal Cord ◽  
Arteriovenous Malformation ◽  
Sexual Function ◽  
Neurological Deficit ◽  
Arteriovenous Malformations ◽  
Vascular Supply ◽  
Conus Medullaris ◽  
Proper Diagnosis ◽  
Spinal Arteriovenous Malformations ◽  
Posterior Spinal Arteries

Abstract: Conus medullaris arteriovenous malformations are an exceedingly rare cause of neurological deficit. They occupy the tip of the spinal cord and can generate motor, sensorty, bowel, bladder, or sexual function deficits. Because of the complex vascular supply of the caudal aspect of the spinal cord, which usually includes multiple feeders from both the anterior and posterior spinal arteries, management may be endovascular, microsurgical, or both. Making the proper diagnosis and distinguishing it from other similar pathologies such as arteriovenous fistula is critical. As with other spinal arteriovenous malformations, it is usually not necessary to pursue the nidus into the spinal cord parenchyma at the time of surgery. This chapter discusses the diagnosis and management of this rare disorder.

Spontaneous occlusion of a spinal arteriovenous malformation: is treatment always necessary?

2010 ◽  
Vol 12 (4) ◽  
pp. 397-401 ◽  
Author(s):  
Pier Paolo Panciani ◽  
Marco Fontanella ◽  
Emanuela Crobeddu ◽  
Bawarjan Schatlo ◽  
Mauro Bergui ◽  
...  
Keyword(s):  
Risk Factors ◽  
Spinal Cord ◽  
Natural History ◽  
Arteriovenous Malformation ◽  
Arteriovenous Malformations ◽  
Genetic Data ◽  
Natural Course ◽  
Spinal Arteriovenous Malformation ◽  
History Of ◽  
Spinal Avm

Knowledge of spinal cord arteriovenous malformations (AVMs) has recently been improved by studies on pathophysiology, neuroimaging, and genetic data. Nevertheless, the natural history of these lesions remains poorly understood. The authors present the case of an angiographic regression of a nidal-type spinal AVM at T-12 to L-1 in a 46-year-old woman with no risk factors. The natural course of untreated lesions is reviewed and discussed. To the best of the authors' knowledge, this is the first study that reports an angiographically proven complete spontaneous occlusion of a spinal AVM.

scholarly journals Perimedullary Spinal Arteriovenous Malformation in an Elderly Female: A Case Report

2021 ◽  
Author(s):  
Madan Basnet ◽  
Suman Gaire ◽  
Abisha Phudong ◽  
Kamal Gautam ◽  
Prarthana Subedhi ◽  
...  
Keyword(s):  
Case Report ◽  
Arteriovenous Malformation ◽  
Arteriovenous Malformations ◽  
Rare Type ◽  
Motor Weakness ◽  
Spinal Arteriovenous Malformation ◽  
Elderly Female ◽  
Spinal Arteriovenous Malformations ◽  
Spinal Avm

Perimedullary spinal AVM is a rare type of spinal arteriovenous malformations. We present a case of 70 yrs female who presented with motor weakness in her bilateral limbs. Initial MRI was misinterpreted as ependymal myxoma; however, histopathology revealed spinal AVM. MRA or DSA should be conducted if AVM is suspected.

INTRADURAL LIPOMAS IN CHILDREN

PEDIATRICS ◽  
1962 ◽  
Vol 29 (6) ◽  
pp. 911-926
Author(s):  
Homer S. Swanson ◽  
Joseph C. Barnett
Keyword(s):  
Spinal Cord ◽  
Neurological Deficit ◽  
Congenital Defects ◽  
Surgical Removal ◽  
Nerve Roots ◽  
Adult Type ◽  
Neurological Condition ◽  
History Of ◽  
Intradural Lipoma ◽  
Subtotal Removal

A series of nine cases of intradural spinal lipomas presenting in childhood or infancy are discussed. In all instances, associated congenital defects and a history of insidious neurological deficit were characteristic findings. In seven of the nine cases a subtotal removal of the intradural lipoma was accomplished, with resulting improvement in the neurological condition. In all instances the pathological interpretation of the lesion was that of an adult type of lipoma. Despite the benign connotations of lipoma, total surgical removal of these lipomas occurring intradurally has often been found not feasible and is probably not necessary. The inclusion of lipoma tissue within the substance of the spinal cord and nerve roots renders manipulation and excision extremely hazardous in terms of retaining the integrity of the nervous structures involved. In these instances subtotal surgical removal and decompression have proven beneficial in all instances in this series. Although exaggeration of neurological deficit may occur postoperatively, if the above surgical principles are adhered to, this deficit is not necessarily of a permanent nature.

Concurrent intracranial and spinal cord arteriovenous malformations

1975 ◽  
Vol 43 (1) ◽  
pp. 104-107 ◽  
Author(s):  
Cecil J. Hash ◽  
Charles B. Grossman ◽  
Henry A. Shenkin
Keyword(s):  
Spinal Cord ◽  
Subarachnoid Hemorrhage ◽  
Arteriovenous Malformation ◽  
Arteriovenous Malformations ◽  
Dural Arteriovenous Malformation ◽  
Content Type ◽  
Spinal Arteriovenous Malformation ◽  
Fine Print

✓ The authors report the case of a patient with subarachnoid hemorrhage in whom an intracranial dural arteriovenous malformation coexisted with a spinal arteriovenous malformation. The latter was considered to be the source of the hemorrhage by clinical and radiographic criteria. It is concluded that patients with subarachnoid hemorrhage who show no suitable intracranial source for their bleed in some instances should be investigated for a spinal origin of hemorrhage.

CASE REPORT ON A RARE NEUROLOGICAL COMPLICATION OF MYCOBACTERIUM TUBERCULOSIS INFECTION IN HIV PATIENT

2021 ◽  
pp. 1-2
Author(s):  
K. Shivaraju ◽  
Mandhala Saikrishna
Keyword(s):  
Spinal Cord ◽  
Mycobacterium Tuberculosis ◽  
Case Report ◽  
Neurological Complication ◽  
Transverse Myelitis ◽  
Sudden Onset ◽  
Lower Limbs ◽  
Tuberculosis Infection ◽  
Mycobacterium Tuberculosis Infection ◽  
History Of

LETM is rarely caused by tuberculosis infection. LETM is a contiguous immune-mediated inammatory lesion of the spinal cord that extends to three or more segments of spinal cord. Here we presenting a case of 55 years old female patient with known HIV infection and no history of tuberculosis infection admitted in the hospital with complains of sudden onset of asymmetrical weakness of lower limbs and urinary incontinence from four days. on evaluation she was underwent some series of investigations, in that nally diagnosed with longitudinally extensive transverse myelitis due to tuberculosis infection. Then patient was treated with ART and ATT with steroids and supportive treatment along with physiotherapy. after some days patient condition was gradually improving with treatment and discharged, advised physiotherapy daily and followup on OPD basis. So based on this case report, we recommend that clinicians should suspect mycobacterium tuberculosis infection when patient diagnosed with transverse myelitis

Spinal Dural Arteriovenous Fistula Presenting with Myelopathy

2019 ◽  
pp. 279-286
Author(s):  
Vinayak Narayan ◽  
Anil Nanda
Keyword(s):  
Spinal Cord ◽  
Arteriovenous Malformations ◽  
Dural Arteriovenous Fistula ◽  
Endovascular Embolization ◽  
Spinal Dural Arteriovenous Fistula ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Degenerative Spinal Disease ◽  
Spinal Arteriovenous Malformations ◽  
Spinal Dural Arteriovenous Fistulas

Abstract: Spinal dural arteriovenous fistulas are a rare cause of congestive myelopathy. Symptoms are insidious in onset and may be confused with degenerative spinal disease. MRI characteristically shows edema of the spinal cord with serpiginous flow voids that follow the surface of the spinal cord. Careful evaluation with spinal angiography is required to ensure accurate diagnosis. Spinal dural arteriovenous fistulas differ from spinal arteriovenous malformations in that most fistulas have only a single fistulous point without a nidus. Spinal dural arteriovenous fistulas may be treated successfully with either surgical resection or endovascular embolization depending on their anatomy. Earlier treatment is associated with better outcomes.

Transient postprandial paresis associated with arteriovenous malformations of the spinal cord

1973 ◽  
Vol 39 (5) ◽  
pp. 652-655 ◽  
Author(s):  
Anthony D. Oliver ◽  
Charles B. Wilson ◽  
Edwin B. Boldrey
Keyword(s):  
Spinal Cord ◽  
Arteriovenous Malformation ◽  
Arteriovenous Malformations ◽  
The Body ◽  
Neurological Deficits ◽  
Clinical Feature ◽  
Content Type ◽  
Spinal Arteriovenous Malformation ◽  
Low Resistance ◽  
Fine Print

✓ Two cases of spinal arteriovenous malformation (AVM) are reported because of a previously unobserved clinical feature: recurrent transient postprandial paresis of the legs. The authors believe the paresis was caused by chronic shunting of blood away from the cord and into the low-resistance AVM. Symptomatic cord ischemia might then be precipitated by vasodilatation in other areas of the body such as the splanchnic, brachial, or uterine vessels. We believe that in some instances this mechanism should be considered as an explanation for episodic neurological deficits seen in association with spinal AVM's.

scholarly journals Microsurgical resection of unruptured cerebellar arteriovenous malformation presenting with trigeminal neuralgia

2021 ◽  
Vol 4 (1) ◽  
pp. V13
Author(s):  
Walter Marani ◽  
Nicola Montemurro ◽  
Shoichiro Tsuji ◽  
Paolo Perrini ◽  
Kosumo Noda ◽  
...  
Keyword(s):  
Natural History ◽  
Trigeminal Neuralgia ◽  
Arteriovenous Malformation ◽  
Arteriovenous Malformations ◽  
Cerebellopontine Angle ◽  
Complete Resection ◽  
Neurovascular Compression ◽  
History Of ◽  
Microsurgical Resection ◽  
Compression Syndromes

Cerebellar arteriovenous malformations (AVMs) represent 10%–15% of all intracranial AVMs and are associated with a greater risk for hemorrhagic presentation compared with supratentorial AVMs. When they reach the cerebellopontine angle cistern, neurovascular compression syndromes, including trigeminal neuralgia and hemifacial spasm, can occur. Due to the aggressive natural history of cerebellar AVM, an effective treatment strategy is required. In this video, the authors demonstrate the technical nuances of microsurgical resection of an unruptured cerebellar AVM in a 24-year-old female presenting with trigeminal neuralgia. The patient underwent right retrosigmoid craniotomy and complete resection of the AVM with resolution of trigeminal neuralgia.The video can be found here: https://youtu.be/6GmNjgFQwx8

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