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Incidental Spinal Vascular Malformations

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Incidental Findings of the Nervous System

Abstract

The evaluation and management of incidentally detected spinal vascular malformations may pose dilemma for every practitioner, since they comprise of about 3–4% of overall spinal cord lesions with the true prevalence unknown. Overall spinal fistulas are more common (70%) followed by arteriovenous malformations (20–30%) but they are also more likely to manifest clinically. Though rare, cavernomas and tumors are the commonest reported incidentally detected lesions. The present chapter describes the types, presentation, diagnostic algorithms, and angio-architectural characteristics to diagnose spinal vascular malformations. We also propose a management algorithm for incidentally detected spinal vascular malformations.

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References

  1. Gaupp J. Hamorrhoiden der Pia Mater Spinalis im Gebiet des Lendenmarks. Beitr Pathol. 1888:516–8.

    Google Scholar 

  2. Krause F. Chirurgie des Gehirns und Rückenmarks. Berlin: Urban & Schwarzenberg; 1911.

    Google Scholar 

  3. Wyburn-Mason R. The vascular abnormalities and tumours of the spinal cord and its membranes. St. Louis: CV Mosby; 1943.

    Google Scholar 

  4. Oldfield EH, Di Chiro G, Quindlen EA, Rieth KG, Doppman JL. Successful treatment of a group of spinal cord arteriovenous malformations by interruption of dural fistula. J Neurosurg. 1983;59(6):1019–30.

    Article  CAS  PubMed  Google Scholar 

  5. Rosenblum B, Oldfield EH, Doppman JL, Di Chiro G. Spinal arteriovenous malformations: a comparison of dural arteriovenous fistulas and intradural AVM’s in 81 patients. J Neurosurg. 1987;67(6):795–802.

    Article  CAS  PubMed  Google Scholar 

  6. Da Costa L, Dehdashti AR, terBrugge KG. Spinal cord vascular shunts: spinal cord vascular malformations and dural arteriovenous fistulas. Neurosurg Focus. 2009;26(1):E6. https://doi.org/10.3171/FOC.2009.26.1.E6. PMID: 19119892.

  7. Jellema K, Canta LR, Tijssen CC, van Rooij WJ, Koudstaal PJ, van Gijn J. Spinal dural arteriovenous fistulas: clinical features in 80 patients. J Neurol Neurosurg Psychiatry. 2003;74(10):1438–40.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Bostroem A, Thron A, Hans FJ, Krings T. Spinal vascular malformations—typical and atypical findings. Zentralbl Neurochir. 2007;68(4):205–13.

    Article  CAS  PubMed  Google Scholar 

  9. Poisson A, Vasdev A, Brunelle F, Plauchu H, Dupuis-Girod S, French Italian HHT, network. Acute paraplegia due to spinal arteriovenous fistula in two patients with hereditary hemorrhagic telangiectasia. Eur J Pediatr. 2009;168(2):135–9.

    Article  PubMed  Google Scholar 

  10. Alexander MJ, Grossi PM, Spetzler RF, McDougall CG. Extradural thoracic arteriovenous malformation in a patient with Klippel-Trenaunay-weber syndrome: case report. Neurosurgery. 2002;51(5):1275–8; discussion 1278–1279.

    Article  PubMed  Google Scholar 

  11. Hu M-H, Wu C-T, Lin K-L, Wong AM-C, Jung S-M, Wu C-T, et al. Intramedullary spinal arteriovenous malformation in a boy of familial cerebral cavernous hemangioma. Childs Nerv Syst. 2008;24(3):393–6.

    Article  PubMed  Google Scholar 

  12. Biondi A, Merland JJ, Hodes JE, Pruvo JP, Reizine D. Aneurysms of spinal arteries associated with intramedullary arteriovenous malformations. I. Angiographic and clinical aspects. AJNR Am J Neuroradiol. 1992;13(3):913–22.

    CAS  PubMed  PubMed Central  Google Scholar 

  13. Zevgaridis D, Medele RJ, Hamburger C, Steiger HJ, Reulen HJ. Cavernous haemangiomas of the spinal cord. A review of 117 cases. Acta Neurochir. 1999;141(3):237–45.

    Article  CAS  PubMed  Google Scholar 

  14. Anson JA, Spetzler RF, Anson J, Spetzler R. Classification of spinal arteriovenous malformations and implications for treatment. BNI Quarterly. 1992;(8):2–8.

    Google Scholar 

  15. Spetzler RF, Detwiler PW, Riina HA, Porter RW. Modified classification of spinal cord vascular lesions. J Neurosurg. 2002;96(2 Suppl):145–56.

    PubMed  Google Scholar 

  16. Berenstein A, Lasjaunias P, terBrugge K, Lasjaunias PL. Surgical neuroangiography: clinical and endovascular treatment aspects in adults, vol. 2. New York: Springer; 2004. p. 847–72.

    Book  Google Scholar 

  17. Eskandar EN, Borges LF, Budzik RF, Putman CM, Ogilvy CS. Spinal dural arteriovenous fistulas: experience with endovascular and surgical therapy. J Neurosurg. 2002;96(2 Suppl):162–7.

    PubMed  Google Scholar 

  18. Criscuolo GR, Oldfield EH, Doppman JL. Reversible acute and subacute myelopathy in patients with dural arteriovenous fistulas. Foix-Alajouanine syndrome reconsidered. J Neurosurg. 1989;70(3):354–9.

    Article  CAS  PubMed  Google Scholar 

  19. Fugate JE, Lanzino G, Rabinstein AA. Clinical presentation and prognostic factors of spinal dural arteriovenous fistulas: an overview. Neurosurg Focus. 2012;32(5):E17.

    Article  PubMed  Google Scholar 

  20. Jellema K, Tijssen CC, van Gijn J. Spinal dural arteriovenous fistulas: a congestive myelopathy that initially mimics a peripheral nerve disorder. Brain. 2006;129(Pt 12):3150–64.

    Article  CAS  PubMed  Google Scholar 

  21. Berenstein A, Lasjaunias P, terBrugge K. Spinal dural arteriovenous fistulae. In: Surgical neuroangiography: Vol 2 Clinical and endovascular treatment aspects in adults. New York: Springer; 2004. pp. 847–72.

    Google Scholar 

  22. Wilson DA, Abla AA, Uschold TD, McDougall CG, Albuquerque FC, Spetzler RF. Multimodality treatment of conus medullaris arteriovenous malformations: 2 decades of experience with combined endovascular and microsurgical treatments. Neurosurgery. 2012;71(1):100–8.

    Article  PubMed  Google Scholar 

  23. Cenzato M, Debernardi A, Stefini R, D’Aliberti G, Piparo M, Talamonti G, et al. Spinal dural arteriovenous fistulas: outcome and prognostic factors. Neurosurg Focus. 2012;32(5):E11.

    Article  PubMed  Google Scholar 

  24. Cosgrove GR, Bertrand G, Fontaine S, Robitaille Y, Melanson D. Cavernous angiomas of the spinal cord. J Neurosurg. 1988;68(1):31–6.

    Article  CAS  PubMed  Google Scholar 

  25. De Marco JK, Dillon WP, Halback VV, Tsuruda JS. Dural arteriovenous fistulas: evaluation with MR imaging. Radiology. 1990;175(1):193–9.

    Article  PubMed  Google Scholar 

  26. Jellema K, Sluzewski M, van Rooij WJ, Tijssen CC, Beute GN. Embolization of spinal dural arteriovenous fistulas: importance of occlusion of the draining vein. J Neurosurg Spine. 2005;2(5):580–3.

    Article  PubMed  Google Scholar 

  27. Doppman JL, Di Chiro G, Dwyer AJ, Frank JL, Oldfield EH. Magnetic resonance imaging of spinal arteriovenous malformations. J Neurosurg. 1987;66(6):830–4.

    Article  CAS  PubMed  Google Scholar 

  28. Barnwell SL, Dowd CF, Davis RL, Edwards MS, Gutin PH, Wilson CB. Cryptic vascular malformations of the spinal cord: diagnosis by magnetic resonance imaging and outcome of surgery. J Neurosurg. 1990;72(3):403–7.

    Article  CAS  PubMed  Google Scholar 

  29. Britz GW, Lazar D, Eskridge J, Winn HR. Accurate intraoperative localization of spinal dural arteriovenous fistulae with embolization coil: technical note. Neurosurgery. 2004;55(1):252–4; discussion 254–255.

    Article  PubMed  Google Scholar 

  30. Kim LJ, Spetzler RF. Classification and surgical management of spinal arteriovenous lesions: arteriovenous fistulae and arteriovenous malformations. Neurosurgery. 2006;59(5 Suppl 3):S195–201; discussion S3–13.

    PubMed  Google Scholar 

  31. Ausman JI, Gold LH, Tadavarthy SM, Amplatz K, Chou SN. Intraparenchymal embolization for obliteration of an intramedullary AVM of the spinal cord. Technical note. J Neurosurg. 1977;47(1):119–25.

    Article  CAS  PubMed  Google Scholar 

  32. Endo T, Aizawa-Kohama M, Nagamatsu K, Murakami K, Takahashi A, Tominaga T. Use of microscope-integrated near-infrared indocyanine green videoangiography in the surgical treatment of intramedullary cavernous malformations: report of 8 cases: clinical article. SPI. 2013;18(5):443–9.

    Article  Google Scholar 

  33. Kharkar S, Shuck J, Conway J, Rigamonti D. The natural history of conservatively managed symptomatic intramedullary spinal cord Cavernomas. Neurosurgery. 2007;60(5):865–72.

    Article  PubMed  Google Scholar 

  34. Logue V. Angiomas of the spinal cord: review of the pathogenesis, clinical features, and results of surgery. J Neurol Neurosurg Psychiatry. 1979;42(1):1–11.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Behrens S, Thron A. Long-term follow-up and outcome in patients treated for spinal dural arteriovenous fistula. J Neurol. 1999;246(3):181–5.

    Article  CAS  PubMed  Google Scholar 

  36. Velat GJ, Chang SW, Abla AA, Albuquerque FC, McDougall CG, Spetzler RF. Microsurgical management of glomus spinal arteriovenous malformations: pial resection technique: clinical article. J Neurosurg Spine. 2012;16(6):523–31.

    Article  PubMed  Google Scholar 

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Jani, P.A., Tripathi, M., Ahuja, C.K., Gupta, S.K. (2023). Incidental Spinal Vascular Malformations. In: Turgut, M., Guo, F., Turgut, A.T., Behari, S. (eds) Incidental Findings of the Nervous System. Springer, Cham. https://doi.org/10.1007/978-3-031-42595-0_26

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  • DOI: https://doi.org/10.1007/978-3-031-42595-0_26

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