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Case Report

Spinal Vascular Malformations: A Review

Robert F.Spetzler , Robert F.Spetzler , L.Fernando Gonzalez , Brendan Killory , Felipe C. Albuquerque

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International Journal of Neurology and Neurosurgery 1(1):p 53-65, January - March 2009. | DOI:

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Abstract

This article summarizes the senior author’s experience (RFS), which has been condensed to a schematic system based on road categories reflecting the anatomy and angioarchitecture of spinal vascular formations. Anatomically, spinal vascular malformations can occur within or outside the dura (i.e., intra- or extradural) and are located anteriorly or posteriorly with respect to the spinal cord. Based on their angiographic appearance, the presence of a nidus defines an arteriovenous malformation (AVM). A lesion is considered an arteriovenous fistula (AVF) if no nidus is present. Vascular malformations involving the spinal cord represent a heterogeneous and challenging group of entities with a broad clinical spectrum that ranges from neurological deficits that develop progressively over years to an insidious presentation caused by an acute hemorrhage.Multiple classification systems are frequently used to categorize these lesions based on multiple clinical and angiographic criteria. This confusing welter of nomenclature only adds to the complexity of treating these challenging lesions.This article summarizes the senior author’s experience (RFS) 36 (Table 1), which has been condensed to a chematic system based on broad categories reflecting the natomy and angioarchitecture of spinal vascular formations. Anatomically, spinal vascular malformations can occur within or utside the dura (i.e., intraor extradural) and are located anteriorly or posteriorly with respect to the spinal cord. Based on their angiographic appearance, the presence of a nidus defines an arteriovenous malformation (AVM).A lesion is considered an arteriovenous fistula (AVF) is no nidus is present.  

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