Endovascular management of spinal vascular malformations

• Published in: Neurosurgical review Vol. 33; no. 1; pp. 1 - 9
• Main Authors: Krings, Timo, Thron, Armin K., Geibprasert, Sasikhan, Agid, Ronit, Hans, Franz J., Lasjaunias, Pierre L., Reinges, Marcus H. T.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 2010
• Subjects: Animals; Arteriovenous Fistula - classification; Arteriovenous Fistula - surgery; Central Nervous System Vascular Malformations - classification; Central Nervous System Vascular Malformations - pathology; Central Nervous System Vascular Malformations - surgery; Humans; Medicine; Medicine & Public Health; Neurosurgery; Neurosurgical Procedures; Regional Blood Flow - physiology; Review; Spinal Diseases - pathology; Spinal Diseases - surgery; Spine - anatomy & histology; Spine - blood supply; Spine - pathology; Spinal dural AV fistula; Spinal AVM; Spinal vascular malformations
• ISSN: 0344-5607; 1437-2320
• DOI: 10.1007/s10143-009-0204-6

Spinal vascular malformations are rare diseases with a wide variety of neurological presentations. In this article, arteriovenous malformations (both from the fistulous and glomerular type) and spinal dural arteriovenous fistulae are described and an overview about their imaging features on magnetic resonance imaging (MRI) and digital subtraction angiography is given. Clinical differential diagnoses, the neurological symptomatology and the potential therapeutic approaches of these diseases which vary depending on the underlying pathology are given. Although MRI constitutes the diagnostic modality of first choice in suspected spinal vascular malformation, a definite diagnosis of the disease and therefore the choice of suited therapeutic approach rests on selective spinal angiography. Treatment in symptomatic patients offers an improvement in the prognosis. In most spinal vascular malformations, the endovascular approach is the method of first choice; in selected cases, a combined or surgical therapy may be considered.