Spine vascular malformation

What is Spinal Vascular Malformation?

Spinal vascular malformation is a very rare condition. It is an abnormal tangle of blood vessels on, in, and/or near the spinal cord 

Depending on where a malformation is located, it is classified as:an intramedullary arteriovenous malformation (AVM within the spinal cord tissue), a pial arteriovenous malformation (AVM on the surface), a dural spinal arteriovenous fistula (DAVF within the membrane that covers the spinal cord), or an epidural arteriovenous fistula (Epidural AVF on the surface of the membrane that covers the spinal cord).

What are the symptoms?

Symptoms usually develop when people are in their 20s, although almost 20 percent of people diagnosed with spinal AVM are under the age of 16.

The emergence of symptoms may be sudden or gradual. Symptoms typically include:

  • Problems with walking or climbing stairs
  • Numbness, tingling or sudden pain in your legs
  • Weakness on one or both sides of your body

As the condition progresses, additional symptoms may include:

  • Sudden, severe back pain
  • Lack of feeling in the legs
  • Difficulty urinating or moving your bowels
  • Headache
  • Stiff neck
  • Sensitivity to light

What are the causes?

The specific cause isn’t known. Most spinal AVMs are present at birth (congenital), but others may occur later in life.

How is a diagnosis made?

  •  Magnetic resonance imaging (MRI)
  • Computed tomography (CT)
  • spinal catheter angiography

What are the treatment options?

Depending on the lesion, the best treatment plan changes. For intramedullary AVMs, partial or palliative treatment is sometimes an option since complete obliteration may carry a much higher chance of causing neurological deficits than conservative management or partial treatment.

The treatment strategy includes catheter embolization, surgical resection, radiation, and/or a combination these modalities.

For pial arteriovenous malformations, complete obliteration may be possible by surgical resection or catheter embolization depending on the anatomy.

 

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