ASCULAR lesions of the spinal cord are a well-recognized entity, having been comprehensively reviewed by Elsberg, 3 Wyburn-Mason, 6 and more recently by Odom. 4 Epidural vascular lesions are commonly hematomas or hemangiomas. Arteriovenous fistulas involving the vertebral vessels in the neck have occasionally been reported? ,2 .~ Nearly all of these fistulas have resulted from penetrating neck injuries, and the venous component has not primarily involved the epidural space. To our knowledge, only a single case of congenital arteriovenous malformation of the vertebral vessels has been reported2 The purpose of this report is to present an unusual case having this rare epidural vascular anomaly in addition to a spinal neurofibroma. We also wish to emphasize the method of angiographic study using selective arterial catheterization with subtraction. Case Report History. The patient, a 17-year-old righthanded Negro male, was admitted on December 17, 1965, with complaints of weakness of the right arm and pain in the neck and right shoulder. While lifting a heavy object in August, 1965, he turned his head from right to left and immediately felt pain in the neck. This later radiated to the right shoulder. The pain was intermittent, occurring 3 to 4 times per day and at night. Cervical motion and coughing increased the pain, which was worse nocturnally. In November, 1965, his neck was stiff and he had a limited range of cervical motion. Numbness began in the right index finger and then involved the remaining fingers of that hand. A progressive weakness of the right arm and

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Arteriograms of 12 patients with space-occupying lesions involving the thalamus were compared with 100 vertebral and carotid arteriograms reported as normal. It was found that masses that involve the thalamus primarily or secondarily affect the choroidal arteries in a characteristic manner. The most commonly involved vessel is the lateral posterior choroidal artery. The medial posterior choroidal artery may also be affected because of its contribution to the dorsal medial nucleus of the thalamus and its occasional course around the pulvinar. Because the anterior choroidal artery is reciprocal in size to the lateral posterior choroidal artery, the lesion will often be demonstrated on carotid angiography.KEY WoaDs thalamus brain tumor ehoroidal artery angiography 1.