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Chapter-19 Spinal Arteriovenous Malformations

BOOK TITLE: Neurovascular Surgical Techniques

Author
1. Jabbour Pascal M
2. Harrop James S
3. Hann Shannon
ISBN
9789350900888
DOI
10.5005/jp/books/11824_19
Edition
1/e
Publishing Year
2013
Pages
9
Author Affiliations
1. Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
2. Jefferson Medical College Philadelphia, PA, Delaware Valley Spinal Cord Injury Center, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA, Thomas Jefferson University, Philadelphia, Pennsylvania, USA, SCI Center Jefferson Medical College, 909 Walnut Street Philadelphia, USA, Division of Spine and Peripheral Nerve Surgery; Delaware Valley SCI Center, Thomas Jefferson University, Philadelphia, Pennsylvania, USA, Delaware Valley SCI Center, Thomas Jefferson University, Philadelphia, Pennsylvania, USA, Delaware Valley, SCI Center, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
3. Thomas Jefferson University, 1000 Walnut Street, Philadelphia, Pennsylvania, USA
Chapter keywords
Spinal arteriovenous malformation, spinal vascular malformations, myelopathic deterioration, dural arteriovenous fistula, glomus arteriovenous malformation, juvenile arteriovenous malformation, intradural arteriovenous fistula, myelography, endovascular occlusion, spinal digital subtraction angiography

Abstract

Spinal arteriovenous malformation (AVM) refers to a rare and diverse subset of spinal vascular malformations (SVMs). Without any treatment, these lesions can lead to severe spinal cord symptoms and progressive myelopathic deterioration. This chapter discusses on classification, diagnosis and management of spinal AVMs. The spinal AVMs are classified into four types based on their location and the anatomy of involved vessels: Type I: Dural arteriovenous fistula, Type II: Glomus arteriovenous malformation, Type III: Juvenile arteriovenous malformation and Type IV: Intradural/Perimedullary arteriovenous fistula. The diagnoses of AVM include magnetic resonance imaging, conventional spinal digital subtraction angiography and myelography. Each spinal vascular malformation is a unique lesion and hence an individualized treatment should be tailored to each individual patient. The present treatment options include open surgical ligation, endovascular occlusion, spinal radiation or combination of these techniques.

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