Thoracolumbar spinal vascular malformation as a rare cause of isolated intraventricular hemorrhage

2014 ◽  
Vol 14 (1) ◽  
pp. 12-15 ◽  
Author(s):  
Evan S. Marlin ◽  
John J. Entwistle ◽  
Michael A. Arnold ◽  
Christopher R. Pierson ◽  
Lance S. Governale
Keyword(s):  
Back Pain ◽  
Venous Thrombosis ◽  
Vascular Malformation ◽  
Intraventricular Hemorrhage ◽  
Vascular Malformations ◽  
Case Reports ◽  
Vascular Lesions ◽  
Spinal Vascular Malformation ◽  
Spinal Vascular Malformations ◽  
Initial Imaging

Spinal vascular malformations are rare vascular lesions that most frequently present with back pain, radiculopathy, and/or myelopathy. Neurological decline is typically secondary to progressive radiculopathy, myelopathy, venous thrombosis, and stroke. Few case reports have described thoracolumbar spinal vascular malformations that present with both subarachnoid and intraventricular hemorrhage. This is the first reported case of a thoracolumbar spinal vascular malformation presenting with isolated intraventricular hemorrhage on initial imaging followed by acute and fatal rehemorrhage.

scholarly journals The contributions of Otto Hebold and Julius Gaupp to the study of spinal vascular malformations: Original documents and historical context

2019 ◽  
Vol 25 (6) ◽  
pp. 604-612
Author(s):  
Philippe Gailloud
Keyword(s):  
Spinal Cord ◽  
Arteriovenous Fistula ◽  
19Th Century ◽  
Vascular Malformation ◽  
Vascular Malformations ◽  
Historical Context ◽  
Journal Articles ◽  
Late 19Th Century ◽  
Spinal Vascular Malformation ◽  
Spinal Vascular Malformations

Book chapters and journal articles dealing with spinal cord vascular malformations often reference Otto Hebold and Julius Gaupp, but frequently misrepresent the observations published by the two German authors in the late 19th century. The purpose of this paper is to provide a better appreciation of these important contributions based on abridged translations of original documents set in their historical context, notably regarding the landmark works of Brasch, Raymond and Cestan, and Lindenmann. It is concluded that Gaupp offered the first reliable description of a perimedullary arteriovenous fistula while the lesion reported by Hebold was not a spinal vascular malformation.

Republished: A lumbar arteriovenous fistula presenting with intraventricular hemorrhage and hydrocephalus

2020 ◽  
Vol 12 (5) ◽  
pp. e5-e5
Author(s):  
Brandon A Miller ◽  
Robert Christopher Spears ◽  
Thomas K Hines ◽  
Abdulnasser Alhajeri ◽  
Justin F Fraser
Keyword(s):  
Arteriovenous Fistula ◽  
Intraventricular Hemorrhage ◽  
Vascular Malformations ◽  
External Ventricular Drain ◽  
Endovascular Embolization ◽  
Unique Case ◽  
Spinal Vascular Malformations ◽  
Csf Diversion ◽  
Initial Imaging ◽  
Lumbar Spinal

Pediatric spinal vascular malformations are rare entities that typically present with symptoms from their effect on surrounding structures. Here we report a unique case of lumbar spinal dural/perimedullary arteriovenous fistula (AVF) that presented with intraventricular hemorrhage and hydrocephalus. The previously healthy child presented with lethargy and headache, and initial imaging revealed only ventriculomegaly with trace intraventricular blood. His mental status improved with CSF diversion via an external ventricular drain. Further workup revealed a spinal AVF that was treated via endovascular embolization. His course was complicated by vasospasm requiring endovascular treatment and he eventually required ventriculoperitoneal shunt placement. He made a full recovery and has returned to his normal activities. This is a unique case of spinal AVF presentation and highlights the importance of considering imaging of the entire neuroaxis during workup for hydrocephalus.

scholarly journals A lumbar arteriovenous fistula presenting with intraventricular hemorrhage and hydrocephalus

2020 ◽  
Vol 13 (3) ◽  
pp. e015631
Author(s):  
Brandon A Miller ◽  
Robert Christopher Spears ◽  
Thomas K Hines ◽  
Abdulnasser Alhajeri ◽  
Justin F Fraser
Keyword(s):  
Arteriovenous Fistula ◽  
Intraventricular Hemorrhage ◽  
Vascular Malformations ◽  
External Ventricular Drain ◽  
Endovascular Embolization ◽  
Unique Case ◽  
Spinal Vascular Malformations ◽  
Csf Diversion ◽  
Initial Imaging ◽  
Lumbar Spinal

Pediatric spinal vascular malformations are rare entities that typically present with symptoms from their effect on surrounding structures. Here we report a unique case of lumbar spinal dural/perimedullary arteriovenous fistula (AVF) that presented with intraventricular hemorrhage and hydrocephalus. The previously healthy child presented with lethargy and headache, and initial imaging revealed only ventriculomegaly with trace intraventricular blood. His mental status improved with CSF diversion via an external ventricular drain. Further workup revealed a spinal AVF that was treated via endovascular embolization. His course was complicated by vasospasm requiring endovascular treatment and he eventually required ventriculoperitoneal shunt placement. He made a full recovery and has returned to his normal activities. This is a unique case of spinal AVF presentation and highlights the importance of considering imaging of the entire neuroaxis during workup for hydrocephalus.

scholarly journals Introduction: Spinal Vascular Malformations

2009 ◽  
Vol 26 (1) ◽  
pp. E1 ◽  
Author(s):  
Edward H. Oldfield
Keyword(s):  
Spinal Cord ◽  
Vascular Malformations ◽  
Vascular Lesions ◽  
Successful Management ◽  
Anatomical Features ◽  
Spinal Vascular Malformations ◽  
Cord Injury ◽  
Selective Arteriography ◽  
The 1960S ◽  
Made In

From the earliest observations of spinal vascular malformations, successful management has been challenging. Initially the challenges were diagnosing, understanding, and treating these lesions. They were originally considered all to be the same, or at least to be a single general type, of disease. With the introduction of selective spinal arteriography in the 1960s and more recently with the introduction and widespread use of MR imaging, the initial challenge of diagnosing spinal vascular malformations was overcome, and significant progress has been made in understanding their anatomy as well as the pathophysiology that underlies the myelopathy commonly associated with them. The anatomical features defined by selective arteriography and the observations permitted with the operating microscope ultimately led to distinctions between the major categories of the vascular lesions affecting the spinal cord; these distinctions were based on the lesions' anatomy, epidemiology, and the mechanism of spinal cord injury.

Volumetric T2-weighted MRI improves the diagnostic accuracy of spinal vascular malformations: comparative analysis with a conventional MR study

2019 ◽  
Vol 11 (10) ◽  
pp. 1019-1023 ◽  
Author(s):  
Santhosh Kumar Kannath ◽  
Adhithyan Rajendran ◽  
Bejoy Thomas ◽  
Jayadevan Enakshy Rajan
Keyword(s):  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Vascular Malformations ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Vascular Lesions ◽  
Volumetric Mri ◽  
Spinal Vascular Malformations ◽  
Sensitivity Specificity ◽  
T2 Mri

BackgroundTo date, very little study of the importance of a volumetric T2-weighted MR sequence in the evaluation of spinal vascular malformations (SVMs) has been carried out.ObjectiveTo determine the utility and accuracy of a volumetric T2 MR sequence compared with conventional T2 in the diagnosis of SVMs.MethodsRetrospective analysis of all patients who underwent spinal DSA for suspected SVMs was conducted. Conventional T2 and volumetric T2 MR images were analysed for the presence of flow voids and parenchymal changes, and SVMs were characterized. The sensitivity, specificity, and overall diagnostic accuracy of these MRI diagnoses were calculated.ResultsOf 89 subjects included in the final analysis, 70 patients had angiographically proved SVMs (38 patients with spinal cord arteriovenous malformations [SCAVM—intramedullary or perimedullary] and 32 cases of spinal dural arteriovenous fistula (SDAVF)) and the remaining 19 subjects were normal. The sensitivity and specificity for identification of SVMs were 98.1% and 90% for volumetric T2 sequences, compared with 82.8% and 89.4% for conventional T2 MRI, respectively. For characterization of spinal vascular lesions, volumetric MRI showed high sensitivity, specificity, and accuracy for SDAVF (100%, 90%, 97%, respectively) compared with conventional T2 MRI (71.8%, 89%, 79%, respectively). The positive likelihood ratio was high and negative likelihood ratio was zero for volumetric MRI evaluation of SDAVF, while these ratios were comparable between the two sequences for SCAVM.ConclusionVolumetric T2 MRI is highly sensitive for the detection of SVMs, especially for SDAVF. Volumetric T2 MRI could be introduced into routine clinical practice in the screening of suspected SVMs.

scholarly journals Early description of synchronous double spinal vascular malformations by Łucja Frey in 1928

2016 ◽  
Vol 25 (2) ◽  
pp. 271-278 ◽  
Author(s):  
Philippe Gailloud
Keyword(s):  
Spinal Cord ◽  
Arteriovenous Malformation ◽  
Vascular Malformation ◽  
Vascular Malformations ◽  
Current Understanding ◽  
Complex Case ◽  
Spinal Arteriovenous Malformation ◽  
Spinal Vascular Malformations ◽  
Early Description ◽  
Auriculotemporal Nerve

The Polish neurologist Łucja Frey (1889–1942) is principally remembered for her description of the auriculotemporal nerve (or Frey's) syndrome. She also reported a complex case of spinal cord vascular malformation in 1928, which included one of the earliest accurate anatomopathological depictions of a spinal arteriovenous malformation as well as the first known observation of double synchronous spinal cord vascular malformation. An abbreviated translation of Frey's report is followed by a discussion of the place occupied by her contribution in the development of our current understanding of spinovascular disorders.

Hemangioma Versus Vascular Malformation: Presence of Nerve Bundle Is a Diagnostic Clue for Vascular Malformation

2005 ◽  
Vol 129 (6) ◽  
pp. 772-775 ◽  
Author(s):  
Patrick A. Adegboyega ◽  
Suimin Qiu
Keyword(s):  
Vascular Malformation ◽  
Detection Method ◽  
Vascular Malformations ◽  
Vascular Lesions ◽  
Stained Glass ◽  
Nerve Bundle ◽  
Glass Slides ◽  
Nerve Bundles ◽  
Diagnostic Clue ◽  
Hematoxylin Eosin

Abstract Context.—Arteriovenous vascular malformations and hemangiomas are benign vascular lesions that are difficult to distinguish from one another clinically. Also, they may be confused with each other at histopathology. Therefore, histochemical stains for the presence of an artery are frequently used to distinguish between the two. Objective.—Because it is clinically relevant to differentiate between arteriovenous vascular malformations and hemangiomas, this study was carried out to explore additional diagnostic clues that may help in the diagnosis and differentiation of these lesions. Design.—A total of 167 cases of benign extracranial vascular lesions were retrieved from the anatomic pathology file of our institution. These comprised 66 cases diagnosed as arteriovenous vascular malformations and 101 cases previously diagnosed as hemangiomas. The hematoxylin-eosin–stained glass slides were reviewed, Movat pentichrome histochemical stain was used to identify elastic vessels (arteries/arterioles), and S100 immunostain was used to identify nerves within these vascular lesions. For immunohistochemistry, the avidin-biotin detection method was used. Results.—With Movat stain, the presence of thick-walled elastic arteries was detected in 12 of the 101 cases previously diagnosed as hemangiomas, and these cases were therefore reclassified as vascular malformations. Using the same criterion, 2 of the 66 cases originally diagnosed as arteriovenous vascular malformations were reclassified as hemangiomas because they lacked arterial structures. Thus, with this strict criterion, we ended up with 91 cases of hemangiomas and 76 cases of arteriovenous vascular malformations. Intralesional nerves were identified in 91% (69/76) of cases of arteriovenous vascular malformations, including all the 12 arteriovenous vascular malformations previously diagnosed as hemangiomas. In contrast, no intralesional nerve was detected in any of the 91 hemangiomas. Conclusions.—These results show that nerve bundles are consistently present in vascular malformations and absent in hemangiomas and so can be used as a diagnostic clue to differentiate between these lesions. Also, in addition to describing a previously unreported component of vascular malformations, these data further confirm the hamartomatous nature of these lesions.

scholarly journals Glut 1, S-100, and Nerve Bundle Study in Vascular Anomalies

2021 ◽  
Author(s):  
Ajay K. Khanna ◽  
Akhilesh Kumar ◽  
Soumya Khanna ◽  
Amrita Kar ◽  
Puneet Kumar ◽  
...  
Keyword(s):  
Vascular Malformation ◽  
Vascular Malformations ◽  
Vascular Anomalies ◽  
Vascular Lesions ◽  
Histological Evaluation ◽  
Vascular Tumors ◽  
Nerve Bundle ◽  
Glut 1 ◽  
S 100 ◽  
Hematoxylin And Eosin

Abstract Vascular anomalies grouped into vascular tumors (hemangioma) (HI) and vascular malformation (VM) are benign vascular lesions that are difficult to distinguish from one another clinically and often confused with each other at histopathology. This confusing terminology leads to improper diagnosis, illogical treatment, and misdirected research. This study aimed to study GLUT 1, S-100, and nerve bundle to differentiate hemangioma and vascular malformation. Thirty two cases of vascular lesions (26 vascular malformations and 6 hemangiomas) were taken into the study. For histological evaluation and immunohistochemistry (IHC), samples of vascular lesions were collected in formalin. All the hematoxylin and eosin-stained slides were evaluated under light microscope for histology and nerve bundles. Immunohistochemical staining was performed by streptavidin–biotin method for GLUT 1 and S-100. GLUT 1 was positive in all 6 cases of hemangiomas (100%) and only in 1 case of vascular malformation. Nerve bundle was present in 24 cases of vascular malformation (92.3%) out of 26 cases but not in any cases of hemangioma and S-100 was found positive in all vascular malformation cases (100%) but not in hemangioma. So GLUT 1 expression, S-100, and presence of nerve bundle in vascular lesions can help to differentiate hemangioma and vascular malformation.

Rotational angiography for diagnosis and surgical planning in the management of spinal vascular lesions

2012 ◽  
Vol 32 (5) ◽  
pp. E6 ◽  
Author(s):  
Alexander E. Ropper ◽  
Ning Lin ◽  
Bradley A. Gross ◽  
Hekmat K. Zarzour ◽  
Ruth Thiex ◽  
...  
Keyword(s):  
Vascular Malformations ◽  
Three Dimensional ◽  
Vascular Pathology ◽  
Vascular Lesions ◽  
Spinal Angiography ◽  
Rotational Angiography ◽  
Spinal Vascular Malformations ◽  
Significant Difference ◽  
Surgical Treatment Planning

Object The management of spinal vascular malformations has undergone significant evolution with the advent of advanced endovascular and angiographic technology. Three-dimensional rotational spinal angiography is an advanced tool that allows the surgeon to gain a better appreciation of the anatomy of these spinal vascular lesions and their relation to surrounding structures. This article describes the use of rotational angiography and 3D reconstructions in the diagnosis and management of spinal vascular malformations. Methods The authors present representative cases involving surgical treatment planning for spinal vascular malformations with focus on the utility and technique of rotational spinal angiography. They report the use of rotational spinal angiography for a heterogeneous collection of vascular pathological conditions. Results Eight patients underwent rotational spinal angiography in addition to digital subtraction angiography (DSA) for the diagnosis and characterization of various spinal vascular lesions. Postprocessed images were used to characterize the lesion in relation to surrounding bone and to enhance the surgeon's ability to precisely localize and obliterate the abnormality. The reconstructions provided superior anatomical detail compared with traditional DSA. No associated complications from the rotational angiography were noted, and there was no statistically significant difference in the amount of radiation exposure to patients undergoing rotational angiography relative to traditional angiography. Conclusions The use of rotational spinal angiography provides a rapid and powerful diagnostic tool, superior to conventional DSA in the diagnosis and preoperative planning of a variety of spinal vascular pathology. A more detailed understanding of the anatomy of such lesions provided by this technique may improve the safety of the surgical approach.

scholarly journals Early Disappearance of Cord Signal Changes following Endovascular Treatment of a Spinal Dural AV Fistula

2005 ◽  
Vol 11 (3) ◽  
pp. 231-234
Author(s):  
S. G. Srikanth ◽  
D. Sivakumar ◽  
P. N. Jayakumar ◽  
M. Veerendrakumar ◽  
M. Thomas
Keyword(s):  
Endovascular Treatment ◽  
Vascular Malformations ◽  
Venous Stasis ◽  
Mr Images ◽  
Spinal Vascular Malformation ◽  
Av Fistula ◽  
Spinal Vascular Malformations ◽  
Signal Changes ◽  
Magnetic Resonance Imaging Mri ◽  
Glue Injection

Spinal dural arterio venous fistulas (SDAVFs) are the commonest type of spinal vascular malformations and are encountered mostly among adult patients. Magnetic Resonance Imaging (MRI) in patients with SDAVFs demonstrates features like spinal cord swelling and signal changes. Cord signal changes are believed to be due to venous stasis. Treatment of a spinal vascular malformation may result in complete or partial resolution of MR findings with associated clinical improvement. The earliest documentation of reduction or disappearance of cord signal changes on post treatment MR images, was one month later in one series in the literature. We present and discuss disappearance of cord signal changes on MRI within 72 hours following endovascular treatment by liquid glue injection in a patient with SDAVF.

Sign in / Sign up

Export Citation Format

Share Document