Metameric spinal AVM: Long-term symptomatic relief achieved by embolization of the extradural component

Drake, Brian; Patro, Satya; Quateen, A; Cora, Elena Adela; Finitsis, Stephanos; Sinclair, John; Lesiuk, Howard; Iancu, Daniela

doi:10.1177/1591019919828135

Cited by 3 publications

(6 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This explains the metameric distribution and involvement of more than one type of tissues in this disease. It is also suggested that the earlier the occurrence of the defect in angiogenesis, the larger will be the area affected in that metameric segment 5 7. In our case, the most dominant supply to the spinal AVF was arising from radiculo-pial branch of right posterior intercostal artery at L3 vertebral level.…”

Section: Discussionmentioning

confidence: 55%

“…Cobb syndrome is a rare clinical entity characterised by presence of spinal arteriovenous vascular malformation/fistula (AVM/AVF) and haemangioma/cutaneous naevus in the same metameric segment. It was first described by Cobb 3–5. Usually, it manifests clinically in late childhood with onset of neurological symptoms although adults are not infrequently affected 6–9.…”

Section: Discussionmentioning

confidence: 99%

“…Attempts to curative embolisation/surgical interventions in these cases pose significant risk of neurological deficits. So, the goal of therapy in most of the cases is halting the progress of the disease rather than to cure it and endovascular partial embolisation is preferred first-line approach 3 5 7 10…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Combined endovascular and surgical management of a case of Cobb syndrome

et al. 2022

View full text Add to dashboard Cite

Cobb syndrome is a rare neurocutaneous disorder characterised by spinal and cutaneous vascular malformations in a metameric distribution. Managing such cases is a challenge for the interventionists and neurosurgeons as the results are often suboptimal. We describe a case of Cobb syndrome in a young male child who presented clinically with acute paraparesis and lower backache. On radiological workup, an intradural perimedullary complex spinal arteriovenous fistula was seen with presence of subarachnoid haemorrhage in the spinal canal and compressive myelopathy. There was a haemangioma in paraspinal muscles and a maculopapular cutaneous lesion in the lower back. He was treated with combined endovascular embolisation and surgical intervention and showed significant clinical improvement on follow-up.

show abstract

Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Combined endovascular and surgical management of a case of Cobb syndrome

et al. 2022

View full text Add to dashboard Cite

show abstract

“…SAMS is classified as extradural-intradural arteriovenous malformations with two or more vascular malformations involving spinal cord, bone, paraspinal musculature, subcutaneous tissues, and/or skin in one or several metameric segments. [ 4 , 11 , 17 , 19 ] The intradural lesion associated with SAMS is mostly nidus-type SCAVMs. [ 13 ] SAMS is rare nonhereditary genetic vascular lesions and account for 6.4% of all spinal arteriovenous lesions.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous regression of extradural high-flow vascular malformation in spinal arteriovenous metameric syndrome (SAMS): A unique case report

Iampreechakul

Chuntaroj

Wattanasen

et al. 2023

Surgical Neurology International

View full text Add to dashboard Cite

Background: Spinal arteriovenous metameric syndrome (SAMS) is a rare nonhereditary genetic vascular disorder, involving multiple layers of tissues in the same metameric level. Spontaneous regression of SAMS has never been reported in the medical literature. Case Description: A 42-year-old woman presented with intermittent low back pain for 6 months. Magnetic resonance imaging of the thoracolumbar spine incidentally found clusters of spinal vascular malformations involving spinal cord, vertebral bodies, epidural space, and paraspinal muscles. There was no sign of venous congestion. Magnetic resonance angiography and spinal angiography revealed intradural spinal cord arteriovenous malformation (SCAVM) at the level of T10-11 and extradural high-flow osseous arteriovenous fistula. Due to asymptomatic SAMS and a high risk of anterior spinal arterial compromise during treatment, conservative treatment was considered in our patient. Spinal angiography obtained 8 years after initial angiography demonstrated significant regression of extradural component of SAMS and stable intradural SCAVM. Conclusion: We describe a unique case of SAMS with spontaneous regression of extradural component during a long-term observation period.

show abstract

“…1 Patients typically present with back pain, bowel and bladder dysfunction, and neurological deficits. 2 Treatment options are endovascular embolization, radiosurgery, microsurgical resection, or a combination approach. 1,3-5 We present the case of a woman in her early 30s with a history of lower back pain whose magnetic resonance imaging findings revealed an intradural, intramedullary spinal AVM.…”

mentioning

confidence: 99%

Microsurgical Resection of a T12 Intramedullary Spinal Arteriovenous Malformation: 2-Dimensional Operative Video

Singh

Srinivasan

Labib

et al. 2022

Operative Neurosurgery

View full text Add to dashboard Cite

Spinal arteriovenous malformations (AVMs) are rare vascular conditions that represent 2% to 4% of all intradural spinal lesions. 1 Patients typically present with back pain, bowel and bladder dysfunction, and neurological deficits. 2 Treatment options are endovascular embolization, radiosurgery, microsurgical resection, or a combination approach. 1,[3][4][5] We present the case of a woman in her early 30s with a history of lower back pain whose magnetic resonance imaging findings revealed an intradural, intramedullary spinal AVM. Patient consent was obtained for the procedure. The patient received preoperative embolization 1 day before surgery. The patient was placed in a prone position, and a midline incision was made. Laminectomies were performed from T10 to T12. The thecal sac was exposed, and a midline dural opening was made. The feeding arteries to the AVM were exposed, cauterized, and divided using microsurgical techniques. The pia was dissected circumferentially from the borders of the AVM. The AVM nidus was directly entered with hemostatic control and mobilized away from adjacent spinal cord parenchyma. The final feeders from the anterior spinal artery were identified and cauterized, allowing for resection of the AVM. The draining vein was cauterized, and flow was inspected with indocyanine green angiography. The patient tolerated the procedure well. She experienced a transient proprioceptive deficit and weakness, which resolved. She was discharged home on postoperative day 5 and returned to normal functioning within 6 weeks. Although reports vary on the optimal treatment for spinal AVMs, microsurgical resection should be considered a safe and effective option.

show abstract

Metameric spinal AVM: Long-term symptomatic relief achieved by embolization of the extradural component

Cited by 3 publications

References 9 publications

Combined endovascular and surgical management of a case of Cobb syndrome

Combined endovascular and surgical management of a case of Cobb syndrome

Spontaneous regression of extradural high-flow vascular malformation in spinal arteriovenous metameric syndrome (SAMS): A unique case report

Microsurgical Resection of a T12 Intramedullary Spinal Arteriovenous Malformation: 2-Dimensional Operative Video

Contact Info

Product

Resources

About