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Journal of Korean Neurosurgical Society > Volume 26(11); 1997 > Article
Journal of Korean Neurosurgical Society 1997;26(11): 1592-1598.
Surgical Treatment of Arteriovenous Malformations of the Spinal Cord.
Sang Ki Chung, Sang Ryong Jeon, Chun Kee Chung, Hyun Jib Kim
1Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
2Department of Neurological Surgery, Asan Medical Center, Seoul, Korea.
ABSTRACT
Spinal arteriovenous malformations(AVM's) may subject patients to the risk of paraplegia or quadriplegia. To determine the clinical features of patients with spinal AVM's, the authors reviewed the medical records of 26 such patients diagnosed and treated in our department, between 1986 and 1996. Among these, there were two cases of dural arteriovenous fistula(dural AVF), eight of perimedullary fistula, twelve of intramedullary AVM, and three of intramedullary cavernous angioma. In one case, the type of AVM was not identified. The most common presenting symptom was acute or slowly progressive myelopathy. The patients were treated with embolization, surgery, or both, and because of residual or recurrent disease, treatment was repeated in six cases, five of which were intramedullary AVM. All patients with dural AVF improved after treatment. Among patients with intradural AVM(perimeudllary AVF or intramedullary AVM), 25% were improved and 25% deteriorated : two of three patients with cavernous angiomas improved. Diagnostic and therapeutic considerations in the cases of AVM of the spinal cord are discussed. Since recurrence or residual arteriovenous shunting is a common problem in the treatment of this condition, follow-up observation of clinical and angiographic findings is mandatory.
Key Words: Spinal cord arteriovenous malformation; Embolization; Dural arteriovenous fistula; Perimedullary arteriovenous fistula; Intramedullary arteriovenous malformation; Cavernous angioma
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