Arteriovenous Malformations of the Spinal Cord

2015 ◽  
pp. 238-266 ◽  
Author(s):  
M. Hurth ◽  
R. Houdart ◽  
R. Djindjian ◽  
A. Rey ◽  
M. Djindjian
Keyword(s):  
Spinal Cord ◽  
Arteriovenous Malformations

Multisession CyberKnife Radiosurgery for Intramedullary Spinal Cord Arteriovenous Malformations

Neurosurgery ◽  
2006 ◽  
Vol 58 (6) ◽  
pp. 1081-1089 ◽  
Author(s):  
John Sinclair ◽  
Steven D. Chang ◽  
Iris C. Gibbs ◽  
John R. Adler
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Magnetic Resonance ◽  
Arteriovenous Malformations ◽  
Conus Medullaris ◽  
Spinal Angiography ◽  
Resonance Imaging ◽  
Intramedullary Spinal Cord ◽  
Cyberknife Radiosurgery

Abstract OBJECTIVE: Intramedullary spinal cord arteriovenous malformations (AVMs) have an unfavorable natural history that characteristically involves myelopathy secondary to progressive ischemia and/or recurrent hemorrhage. Although some lesions can be managed successfully with embolization and surgery, AVM size, location, and angioarchitecture precludes treatment in many circumstances. Given the poor outlook for such patients, and building on the successful experience with radiosurgical ablation of cerebral AVMs, our group at Stanford University has used CyberKnife (Accuray, Inc., Sunnyvale, CA) stereotactic radiosurgery (SRS) to treat selected spinal cord AVMs since 1997. In this article, we retrospectively analyze our preliminary experience with this technique. METHODS: Fifteen patients with intramedullary spinal cord AVMs (nine cervical, three thoracic, and three conus medullaris) were treated by image-guided SRS between 1997 and 2005. SRS was delivered in two to five sessions with an average marginal dose of 20.5 Gy. The biologically effective dose used in individual patients was escalated gradually over the course of this study. Clinical and magnetic resonance imaging follow-up were carried out annually, and spinal angiography was repeated at 3 years. RESULTS: After a mean follow-up period of 27.9 months (range, 3–59 mo), six of the seven patients who were more than 3 years from SRS had significant reductions in AVM volumes on interim magnetic resonance imaging examinations. In four of the five patients who underwent postoperative spinal angiography, persistent AVM was confirmed, albeit reduced in size. One patient demonstrated complete angiographic obliteration of a conus medullaris AVM 26 months after radiosurgery. There was no evidence of further hemorrhage after CyberKnife treatment or neurological deterioration attributable to SRS. CONCLUSION: This description of CyberKnife radiosurgical ablation demonstrates its feasibility and apparent safety for selected intramedullary spinal cord AVMs. Additional experience is necessary to ascertain the optimal radiosurgical dose and ultimate efficacy of this technique.

ARTERIOVENOUS MALFORMATIONS OF THE BRAIN AND SPINAL CORD

2002 ◽  
pp. 595-608
Author(s):  
Soke Miang Chng ◽  
Hortensia Alvarez ◽  
Georges Rodesch ◽  
Pierre Lasjaunias
Keyword(s):  
Spinal Cord ◽  
Arteriovenous Malformations ◽  
Brain And Spinal Cord ◽  
The Brain

Endovascular Therapy for Arteriovenous Malformations and Fistulae in the Spinal Cord

1993 ◽  
Vol 10 (03) ◽  
pp. 227-242 ◽  
Author(s):  
Y. Gobin ◽  
Emmanuel Houdart ◽  
Alfredo Casasco ◽  
Jean-Jacques Merland
Keyword(s):  
Spinal Cord ◽  
Endovascular Therapy ◽  
Arteriovenous Malformations

scholarly journals Treatment of Intramedullary Arteriovenous Malformations of the Spinal Cord

2000 ◽  
Vol 6 (1_suppl) ◽  
pp. 203-207 ◽  
Author(s):  
S. Ushikoshi ◽  
K. Hida ◽  
Y. Kikuchi ◽  
Y. Iwasaki ◽  
K. Miyasaka ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Arteriovenous Malformations ◽  
Radical Excision ◽  
Arteriovenous Fistulas ◽  
First Choice ◽  
Choice Of Treatment ◽  
Technical Complication ◽  
Surgical Manipulation ◽  
Residual Lesions

We retrospectively reviewed our treatment results for spinal intramedullary arteriovenous malformations (AVMs). Fifteen consecutive patients were included in this syudy. Five patient underwent particulate embolization. Surgery was performed in ten patients (including two patient who were treated embolization initially). Five patients, at the beginning of our experience, underwent radical excision of the nidus via the posterior myelotomy. Recent five patients underwent interruption of the feeding pedicles on the surface of the spinal cord. Especially when arteriovenous fistulas (AVFs) or aneurysms were demonstrated, accurate obliteration of them were performed. Four patients, including two with residual AVM after the surgery, underwent irradiation therapy. Anatomically, four AVMs disappeared completely and the other 11 patients have a residual lesions after the treatment. Clinically, three patients improved, six remained unchanged, and six worsened. The causes of neurological deterioration after the treatment were technical complication of embolization in one patient and surgical manipulation in five. There was no patient who experienced hemorrhage during the follow-up period ranged from 6 months to 17 years, with a mean of 7.5 years. In conclusion, particulate embolization should be considered as the first choice of treatment if feasible. Surgical treatment is indicated for the dangerous anatomical features such as AVFs or aneurysms.

Arteriovenous malformations (AVM) of the spinal cord in children

1982 ◽  
Vol 22 (4) ◽  
pp. 171-180 ◽  
Author(s):  
M. C. Riche ◽  
J. Modenesi-Freitas ◽  
M. Djindjian ◽  
J. J. Merland
Keyword(s):  
Spinal Cord ◽  
Arteriovenous Malformations

scholarly journals Multifocal and Metameric Spinal Cord Arteriovenous Malformations

1999 ◽  
Vol 5 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Y. Matsumaru ◽  
S. Pongpech ◽  
J. Laothamas ◽  
H. Alvarez ◽  
G. Rodesch ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Neural Crest ◽  
Arteriovenous Malformations ◽  
Vascular Malformations ◽  
Vascular Lesions ◽  
Frequent Type ◽  
Associated Lesions ◽  
Neural Crest Origin ◽  
Cord Lesion

We describe 19 (16.0%) multiple vascular malformations (AVMs) in 119 spinal cord arteriovenous malformations (SCAVMs). The associated lesions were eight vertebral vascular malformations, two cutaneous, four limbs, four radicular AVMs, three bifocal SCAVMs; one patient had a bifocal cord lesion associated with vertebral and limb localisations. Various syndromic associations were seen: nine Cobb, two Klippel-Trenaunay-Weber, one Parkes Weber. An additional subgroup of unclassified associations is constituted by seven cases with bifocal intradural uni or multimetamerk lesions. In our SCAVMs series, the incidence of multiple vascular lesions is high, in particular multifocal intradural malformations. Metameric distribution is the most frequent type of multiplicity. Identification of the myelomeric level involved in SCAVM allows segmental link between various lesions of mesodermal or neural crest origin to be discussed.

Sign in / Sign up

Export Citation Format

Share Document