Vascular Myelopathies

Parham Moftakhar; Steven W. Hetts; Nerissa U. Ko

doi:10.1055/s-0032-1322585

Seminars in Neurology, Inhaltsverzeichnis

Semin Neurol 2012; 32(02): 146-153
DOI: 10.1055/s-0032-1322585

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Vascular Myelopathies

Parham Moftakhar

¹Department of Radiology and Biomedical Imaging, UCSF Medical Center, University of California, San Francisco, California

,

Steven W. Hetts

²Division of Interventional Neuroradiology, Department of Radiology, UCSF Medical Center, University of California, San Francisco, California

,

Nerissa U. Ko

³Division of Neurovascular Service, Department of Neurology, UCSF Medical Center, University of California, San Francisco, California

› Institutsangaben

Abstract

Vascular abnormalities of the spinal cord are an important cause of myelopathy. Clinicians need to be aware of these disorders as they can present with a variety of neurologic symptoms ranging from acute spinal neurologic emergencies, relapsing/remitting spells to gradually progressive dysfunction. The unique topography and vascular anatomy of the spinal cord lends to the variety of clinical presentations. Both ischemic and hemorrhagic insults can occur. Increased clinical suspicion, better detection with newer imaging modalities and early treatment can often impact outcomes. The authors review clinical diagnoses, novel imaging, and advanced treatment modalities for the most common causes of vascular myelopathy.

Keywords

spinal cord - arteriovenous malformation - dural fistula - cavernoma - myelopathy

Volltext

Referenzen

References
1 Aminoff MJ, Logue V. Clinical features of spinal vascular malformations. Brain 1974; 97 (1) 197-210
2 da Costa L, Dehdashti AR, terBrugge KG. Spinal cord vascular shunts: spinal cord vascular malformations and dural arteriovenous fistulas. Neurosurg Focus 2009; 26 (1) E6
3 Willinsky R. Spinal cord arteriovenous malformations. In: Marks M, Do H, eds. Endovascular and Percutaneous Therapy of the Brain and Spine. Philadelphia, PA: Lippincott Williams & Wilkins; 2002: 415-448
4 Muraszko KM, Oldfield EH. Vascular malformations of the spinal cord and dura. Neurosurg Clin N Am 1990; 1 (3) 631-652
5 Lev N, Maimon S, Rappaport ZH, Melamed E. Spinal dural arteriovenous fistulae—a diagnostic challenge. Isr Med Assoc J 2001; 3 (7) 492-496
6 Merland JJ, Riche MC, Chiras J. Intraspinal extramedullary arteriovenous fistulae draining into the medullary veins. J Neuroradiol 1980; 7 (4) 271-320
7 Kataoka H, Miyamoto S, Nagata I, Ueba T, Hashimoto N. Venous congestion is a major cause of neurological deterioration in spinal arteriovenous malformations. Neurosurgery 2001; 48 (6) 1224-1229 , discussion 1229–1230
8 Atkinson JL, Miller GM, Krauss WE , et al. Clinical and radiographic features of dural arteriovenous fistula, a treatable cause of myelopathy. Mayo Clin Proc 2001; 76 (11) 1120-1130
9 Van Dijk JM, TerBrugge KG, Willinsky RA, Farb RI, Wallace MC. Multidisciplinary management of spinal dural arteriovenous fistulas: clinical presentation and long-term follow-up in 49 patients. Stroke 2002; 33 (6) 1578-1583
10 Koch C. Spinal dural arteriovenous fistula. Curr Opin Neurol 2006; 19 (1) 69-75
11 Gilbertson JR, Miller GM, Goldman MS, Marsh WR. Spinal dural arteriovenous fistulas: MR and myelographic findings. AJNR Am J Neuroradiol 1995; 16 (10) 2049-2057
12 Krings T, Lasjaunias PL, Hans FJ , et al. Imaging in spinal vascular disease. Neuroimaging Clin N Am 2007; 17 (1) 57-72
13 Krings T, Geibprasert S. Spinal dural arteriovenous fistulas. AJNR Am J Neuroradiol 2009; 30 (4) 639-648
14 Narvid J, Hetts SW, Larsen D , et al. Spinal dural arteriovenous fistulae: clinical features and long-term results. Neurosurgery 2008; 62 (1) 159-166 , discussion 166–167
15 Geibprasert S, Pongpech S, Jiarakongmun P, Krings T. Cervical spine dural arteriovenous fistula presenting with congestive myelopathy of the conus. J Neurosurg Spine 2009; 11 (4) 427-431
16 Andersson T, van Dijk JM, Willinsky RA. Venous manifestations of spinal arteriovenous fistulas. Neuroimaging Clin N Am 2003; 13 (1) 73-93
17 Tacconi L, Lopez Izquierdo BC, Symon L. Outcome and prognostic factors in the surgical treatment of spinal dural arteriovenous fistulas. A long-term study. Br J Neurosurg 1997; 11 (4) 298-305
18 Symon L, Kuyama H, Kendall B. Dural arteriovenous malformations of the spine. Clinical features and surgical results in 55 cases. J Neurosurg 1984; 60 (2) 238-247
19 Niimi Y, Berenstein A, Setton A, Neophytides A. Embolization of spinal dural arteriovenous fistulae: results and follow-up. Neurosurgery 1997; 40 (4) 675-682 , discussion 682–683
20 Song JK, Vinuela F, Gobin YP , et al. Surgical and endovascular treatment of spinal dural arteriovenous fistulas: long-term disability assessment and prognostic factors. J Neurosurg 2001; 94 (2, Suppl) 199-204
21 Westphal M, Koch C. Management of spinal dural arteriovenous fistulae using an interdisciplinary neuroradiological/neurosurgical approach: experience with 47 cases. Neurosurgery 1999; 45 (3) 451-457 , discussion 457–458
22 Rodesch G, Lasjaunias P. Spinal cord arteriovenous shunts: from imaging to management. Eur J Radiol 2003; 46 (3) 221-232
23 Biondi A, Merland JJ, Hodes JE, Aymard A, Reizine D. Aneurysms of spinal arteries associated with intramedullary arteriovenous malformations. II. Results of AVM endovascular treatment and hemodynamic considerations. AJNR Am J Neuroradiol 1992; 13 (3) 923-931
24 Biondi A, Merland JJ, Hodes JE, Pruvo JP, Reizine D. Aneurysms of spinal arteries associated with intramedullary arteriovenous malformations. I. Angiographic and clinical aspects. AJNR Am J Neuroradiol 1992; 13 (3) 913-922
25 Rosenblum B, Oldfield EH, Doppman JL, Di Chiro G. Spinal arteriovenous malformations: a comparison of dural arteriovenous fistulas and intradural AVM's in 81 patients. J Neurosurg 1987; 67 (6) 795-802
26 Yaşargil MG, Symon L, Teddy PJ. Arteriovenous malformations of the spinal cord. Adv Tech Stand Neurosurg 1984; 11: 61-102
27 Shephard RH. Spinal arteriovenous malformations and subarachnoid haemorrhage. Br J Neurosurg 1992; 6 (1) 5-12
28 Cobb S. Haemangioma of the spinal cord: associated with skin naevi of the same metamere. Ann Surg 1915; 62 (6) 641-649
29 Sinclair J, Chang SD, Gibbs IC, Adler Jr JR. Multisession CyberKnife radiosurgery for intramedullary spinal cord arteriovenous malformations. Neurosurgery 2006; 58 (6) 1081-1089 , discussion 1081–1089
30 Bao YH, Ling F. Classification and therapeutic modalities of spinal vascular malformations in 80 patients. Neurosurgery 1997; 40 (1) 75-81
31 Kim LJ, Spetzler RF. Classification and surgical management of spinal arteriovenous lesions: arteriovenous fistulae and arteriovenous malformations. Neurosurgery 2006; 59 (5, Suppl 3) S195-S201 , discussion S3–S13
32 Spetzler RF, Detwiler PW, Riina HA, Porter RW. Modified classification of spinal cord vascular lesions. J Neurosurg 2002; 96 (2, Suppl) 145-156
33 Tai PA, Tu YK, Liu HM. Surgical treatment of spinal arteriovenous malformations: vascular anatomy and surgical outcome. J Formos Med Assoc 2001; 100 (6) 389-396
34 Detweiler PW, Porter RW, Spetzler RF. Spinal arteriovenous malformations. Neurosurg Clin N Am 1999; 10 (1) 89-100
35 Liu A-H, Gobin P, Riina H. Endovascular surgery for vascular malformations of the spinal cord. Oper Tech Neurosurg 2003; 6 (3) 163-170
36 Corkill RA, Mitsos AP, Molyneux AJ. Embolization of spinal intramedullary arteriovenous malformations using the liquid embolic agent, Onyx: a single-center experience in a series of 17 patients. J Neurosurg Spine 2007; 7 (5) 478-485
37 Veznedaroglu E, Nelson PK, Jabbour PM, Rosenwasser RH. Endovascular treatment of spinal cord arteriovenous malformations. Neurosurgery 2006; 59 (5, Suppl 3) S202-S209 , discussion S3–S13
38 Doppman JL, Di Chiro G, Ommaya A. Obliteration of spinal-cord arteriovenous malformation by percutaneous embolisation. Lancet 1968; 1 (7540) 477
39 Djindjian R, Cophignon J, Rey A, Théron J, Merland JJ, Houdart R. Superselective arteriographic embolization by the femoral route in neuroradiology. Study of 50 cases. II. Embolization in vertebromedullary pathology. Neuroradiology 1973; 6 (3) 132-142
40 Sure U, Wakat JP, Gatscher S, Becker R, Bien S, Bertalanffy H. Spinal type IV arteriovenous malformations (perimedullary fistulas) in children. Childs Nerv Syst 2000; 16 (8) 508-515
41 Djindjian M, Djindjian R, Rey A, Hurth M, Houdart R. Intradural extramedullary spinal arterio-venous malformations fed by the anterior spinal artery. Surg Neurol 1977; 8 (2) 85-93
42 Krings T, Mull M, Gilsbach JM, Thron A. Spinal vascular malformations. Eur Radiol 2005; 15 (2) 267-278
43 Antonietti L, Sheth SA, Halbach VV , et al. Long-term outcome in the repair of spinal cord perimedullary arteriovenous fistulas. AJNR Am J Neuroradiol 2010; 31 (10) 1824-1830
44 Kendall BE, Logue V. Spinal epidural angiomatous malformations draining into intrathecal veins. Neuroradiology 1977; 13 (4) 181-189
45 Deans WR, Bloch S, Leibrock L, Berman BM, Skultety FM. Arteriovenous fistula in patients with neurofibromatosis. Radiology 1982; 144 (1) 103-107
46 Hui F, Trosselo MP, Meisel HJ, Alvarez H, Sequeira E, Lasjaunias P. Paraspinal arteriovenous shunts in children. Neuroradiology 1994; 36 (1) 69-73
47 Arnaud O, Bille F, Pouget J, Serratrice G, Salamon G. Epidural arteriovenous fistula with perimedullary venous drainage: case report. Neuroradiology 1994; 36 (6) 490-491
48 Halbach VV, Higashida RT, Hieshima GB. Treatment of vertebral arteriovenous fistulas. AJR Am J Roentgenol 1988; 150 (2) 405-412
49 Szajner M, Weill A, Piotin M, Moret J. Endovascular treatment of a cervical paraspinal arteriovenous malformation via arterial and venous approaches. AJNR Am J Neuroradiol 1999; 20 (6) 1097-1099
50 Lu DC, Lawton MT. Clinical presentation and surgical management of intramedullary spinal cord cavernous malformations. Neurosurg Focus 2010; 29 (3) E12
51 Weinzierl MR, Krings T, Korinth MC, Reinges MH, Gilsbach JM. MRI and intraoperative findings in cavernous haemangiomas of the spinal cord. Neuroradiology 2004; 46 (1) 65-71
52 Sohn MJ, Lee DJ, Jeon SR, Khang SK. Spinal radiosurgical treatment for thoracic epidural cavernous hemangioma presenting as radiculomyelopathy: technical case report. Neurosurgery 2009; 64 (6) E1202-E1203 , discussion E1203
53 Harrison MJ, Eisenberg MB, Ullman JS, Oppenheim JS, Camins MB, Post KD. Symptomatic cavernous malformations affecting the spine and spinal cord. Neurosurgery 1995; 37 (2) 195-204 , discussion 204–205
54 Padovani R, Acciarri N, Giulioni M, Pantieri R, Foschini MP. Cavernous angiomas of the spinal district: surgical treatment of 11 patients. Eur Spine J 1997; 6 (5) 298-303
55 De Salles AA, Pedroso AG, Medin P , et al. Spinal lesions treated with Novalis shaped beam intensity-modulated radiosurgery and stereotactic radiotherapy. J Neurosurg 2004; 101 (Suppl. 03) 435-440
56 Rock JP, Ryu S, Yin FF, Schreiber F, Abdulhak M. The evolving role of stereotactic radiosurgery and stereotactic radiation therapy for patients with spine tumors. J Neurooncol 2004; 69 (1–3) 319-334
57 Ryu S, Jin JY, Jin R , et al. Partial volume tolerance of the spinal cord and complications of single-dose radiosurgery. Cancer 2007; 109 (3) 628-636