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.

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.

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.

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.

scholarly journals Successful treatment of bilateral multiple pulmonary arteriovenous malformations in a patient with brain abscess and severe hypoxemia using a combination of transcatheter embolotherapy and surgical resection: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Takahiro Ochi ◽  
Masako Chiyo ◽  
Takamasa Ito ◽  
Hideharu Furumoto ◽  
Toshihiko Sugiura ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Brain Abscess ◽  
Surgical Resection ◽  
Arteriovenous Malformations ◽  
Pulmonary Arteriovenous Malformation ◽  
Positive Pressure ◽  
Pulmonary Arteriovenous Malformations ◽  
Severe Hypoxemia ◽  
History Of ◽  
The Brain

Abstract Background A pulmonary arteriovenous malformation is an abnormal dilated blood vessel that makes direct communication between a pulmonary artery and pulmonary vein and can be associated with hypoxemia or neurological complications, including brain abscess and cerebral infarction. Treatment of pulmonary arteriovenous malformation includes surgical resection and transcatheter embolotherapy, however the adaptation of therapies should be considered when a patient is in bad condition. Case presentation A 51-year-old man was admitted after developing fever, consciousness disorder, and hypoxemia. Magnetic resonance imaging of the brain showed a brain abscess. Bilateral pulmonary arteriovenous malformations were found by contrast computed tomography. Because of a family history of pulmonary arteriovenous malformation, a history of epistaxis, and the existence of oral mucosa telangiectasia, he was diagnosed with hereditary hemorrhagic telangiectasia and brain abscess caused by intrapulmonary right-to-left shunt. The brain abscess improved with antibiotic treatment; however, the administration of oxygen did not ameliorate his hypoxemia. His hypoxemia was exacerbated by positive pressure ventilation. Considering his systemic and respiratory condition, we considered surgery to involve a high degree of risk. After controlling his brain abscess and pneumonia, transcatheter embolotherapy was performed. This improved his systemic condition, enabling surgical treatment. Conclusions This middle-aged patient suffering from brain abscess and severe hypoxemia with multiple pulmonary arteriovenous malformations was successfully treated by a combination of transcatheter embolotherapy and surgery. The adaptation and combination of therapies, as well as the sequence of treatments, should be considered depending on the patient status and lesions.

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 De novo arteriovenous malformation in a patient with hereditary hemorrhagic telangiectasia

2016 ◽  
Vol 17 (3) ◽  
pp. 330-335 ◽  
Author(s):  
Yusuke Shimoda ◽  
Toshiya Osanai ◽  
Naoki Nakayama ◽  
Satoshi Ushikoshi ◽  
Masaaki Hokari ◽  
...  
Keyword(s):  
Family History ◽  
Arteriovenous Malformation ◽  
Hereditary Hemorrhagic Telangiectasia ◽  
Arteriovenous Malformations ◽  
Autosomal Dominant ◽  
De Novo ◽  
The Family ◽  
Systemic Disorder ◽  
History Of ◽  
Cerebral Avms

Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant systemic disorder characterized by the enlargement of capillaries, recurrent nosebleeds, and multiple arteriovenous malformations (AVMs). Although cerebral AVMs are traditionally considered to be congenital lesions, some reports have described de novo AVMs, which suggests that the authors believed them to be dynamic conditions. In this article, the authors describe the case of a 5-year-old boy with HHT in whom a de novo cerebral AVM was detected after a negative MRI result at 5 months. To the authors’ knowledge, this is the first report of a de novo AVM in a patient with HHT. In patients with a family history of HHT, de novo AVMs are possible, even when no lesions are detected at the first screening. Therefore, regular screenings need to be performed, and the family should be informed that AVMs could still develop despite normal MRI results.

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