[Vertebro-epidural lumbosacral vascular malformations. An unusual cause of lumbo-sciatic pain].
Sciatica is most commonly caused by nerve root compression secondary to herniated disk. Rarely, it can be due to a lumbosacral vascular malformation. We present five cases with such a malformation, presenting as a chronic lumboradiculagia. The patients were explored with computed tomography, MRI and selective spinal angiography. Polymorphic anatomic and hemodynamic aspect of these cases are reported: 1. One vertebral hemangioma with epidural extension; 2. Three purely epidural malformations: a) one epidural cavernous hemangioma, b) one epidural arteriovenous malformation, c) one epidural varix; 3. One paravertebral arteriovenous fistula with epidural venous drainage. Diagnosis of these rare malformations may be difficult. A multiplanar cross-sectional magnetic resonance and computed tomography scan with contrast enhancement can show characteristic abnormalities and may assist in recognition these malformations. Selective spinal angiography confirms the diagnosis, allows to classify the malformation and is required to evaluate endovascular therapeutic possibilities.
Demeulenaere
A
A
Service de Neuroradiologie Charcot, Hôpital de La Salpêtrière, Paris.
Spelle
L
L
Lafitte
F
F
Brunet
E
E
Chiras
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000792:Angiography; D001164:Arteriovenous Fistula / Q000150:complications / Q000175:diagnosis; D001808:Blood Vessels / Q000002:abnormalities*; D002908:Chronic Disease; D004824:Epidural Space; D005260:Female; D006391:Hemangioma / Q000150:complications / Q000175:diagnosis; D006392:Hemangioma, Cavernous / Q000150:complications / Q000175:diagnosis; D006801:Humans; D007091:Image Processing, Computer-Assisted; D017116:Low Back Pain / Q000209:etiology*; D008159:Lumbar Vertebrae / Q000098:blood supply*; D008279:Magnetic Resonance Imaging; D008297:Male; D009408:Nerve Compression Syndromes / Q000209:etiology; D010523:Peripheral Nervous System Diseases / Q000209:etiology; D012447:Sacrum / Q000098:blood supply*; D012585:Sciatica / Q000209:etiology*; D013125:Spinal Neoplasms / Q000150:complications / Q000175:diagnosis; D013126:Spinal Nerve Roots / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014648:Varicose Veins / Q000150:complications / Q000175:diagnosis