Combined Spinal Arteriovenous Malformation and Spinal Dysraphism

World Neurosurg. 2018 Feb:110:407-413. doi: 10.1016/j.wneu.2017.11.162. Epub 2017 Dec 6.

Abstract

Background: Spinal vascular malformations as a group are rare, and coexistence of a spinal arteriovenous malformation (AVM) in or around the spinal dysraphism is extremely rare. We report 2 cases of combined spinal dysraphism and vascular malformations of the spinal cord.

Case description: The first case was an AVM located in a filum terminale lipoma fed by the artery of the filum terminale. This case was managed by multiple endovascular embolizations followed by surgery. The second case was an AVM located in a lumbar lipomyelocele managed by endovascular embolization. These cases illustrate the imaging findings of a rare entity and present the diagnostic and therapeutic challenges.

Conclusions: Endovascular embolization combined with surgical resection is the most commonly used treatment for spinal dysraphism with spinal cord AVM. Careful analysis of spinal angiography is necessary owing to the distorted vascular and surgical anatomy of the region affected by spinal dysraphism.

Keywords: Embolization; Spinal arteriovenous malformation; Spinal dysraphism.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Arteriovenous Malformations / complications*
  • Arteriovenous Malformations / diagnostic imaging
  • Arteriovenous Malformations / therapy
  • Cauda Equina / blood supply
  • Cauda Equina / diagnostic imaging
  • Central Nervous System Vascular Malformations / complications*
  • Central Nervous System Vascular Malformations / diagnostic imaging
  • Central Nervous System Vascular Malformations / therapy
  • Embolization, Therapeutic
  • Humans
  • Male
  • Middle Aged
  • Neurosurgical Procedures
  • Spinal Cord / abnormalities*
  • Spinal Cord / blood supply*
  • Spinal Cord / diagnostic imaging
  • Spinal Dysraphism / complications*
  • Spinal Dysraphism / diagnostic imaging
  • Spinal Dysraphism / therapy