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Two pediatric observations of spinal extradural arteriovenous fistulas presenting with epidural hemorrhages and cord compression

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Abstract

We report two cases of acute spinal cord compression in children with low-flow spinal epidural arteriovenous fistulas (SEAVFs) and discuss the clinical presentation and management of these vascular anomalies. While most low-flow SEAVFs without radiculomedullary drainage are benign lesions typically diagnosed incidentally, we suggest that asymptomatic lesions may warrant aggressive management in specific circumstances, including lesions diagnosed at an early age or in patients under anticoagulation therapy. Our observations also emphasize that patients with a “spontaneous” epidural hemorrhage should undergo dedicated preoperative or postoperative vascular imaging to identify a possible underlying vascular anomaly.

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Authors and Affiliations

  1. Division of Interventional Neuroradiology, The Johns Hopkins Hospital, The Johns Hopkins University, 1800 E Orleans Street, Baltimore, MD, 21287, USA

    Alessandra Rigamonti & Philippe Gailloud

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  1. Alessandra Rigamonti
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  2. Philippe Gailloud
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Contributions

Rigamonti A — Conceptualization, original draft preparation, images preparation. Gailloud P — Conceptualization, review and editing, supervision.

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Correspondence to Philippe Gailloud.

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Case reports of three patients or fewer are not subject to IRB approval at the authors’ institution. Informed consent was obtained from patients and families for the reported clinical procedures performed as routine clinical studies and accessed retrospectively for preparing this report.

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P. Gailloud is a paid consultant for Cerenovus

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Rigamonti, A., Gailloud, P. Two pediatric observations of spinal extradural arteriovenous fistulas presenting with epidural hemorrhages and cord compression. Childs Nerv Syst 40, 597–601 (2024). https://doi.org/10.1007/s00381-023-06193-8

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  • DOI: https://doi.org/10.1007/s00381-023-06193-8

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