[Surgical treatment of the thoracic arterio-venous malformation with intraspinal and extraspinal niduses (author's transl)].
Recent advances in the technique of selective spinal angiography and microsurgery have provided us remarkable progress in diagnosis and treatment of spinal arteriovenous malformation. Although in some cases total extirpation is still difficult, various attempts have been performed for complete cure. In this paper, the authors reported a case of 6-year-old girl who complained of the progressive gait disturbance. In this case we found the thoracic AVM which had niduses not only in the intraspinal canal but also in the extraspinal space. Transthoracic ligature was performed in this case. That is, through a thoracotomy with rib resection on the right side, the enlarged anomalous feeding artery, i.e., intercostal artery with its branches, from which Adamkiewicz's artery should be derived was ligated and clipped. And the result was good. In Japan, we have never had a report of such surgical method for AVM. Besides such a case is very rare that the AVM had nidus extending to both intra- and extra-spinal canal space. So we discussed the treatment against such an AVM with the investigations of literatures. Further follow-up study for this case will be reported later. The paper was read by the authors at the 53rd Kyushu region meeting of Japan Neurological Society (February 28, 1976, Kagoshima).
D001165:Arteriovenous Malformations / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D008026:Ligation; D013116:Spinal Cord / Q000098:blood supply*; D013895:Thoracic Arteries / Q000601:surgery