Endovascular management of spinal vascular malformations.
Spinal vascular malformations are rare diseases with a wide variety of neurological presentations. In this article, arteriovenous malformations (both from the fistulous and glomerular type) and spinal dural arteriovenous fistulae are described and an overview about their imaging features on magnetic resonance imaging (MRI) and digital subtraction angiography is given. Clinical differential diagnoses, the neurological symptomatology and the potential therapeutic approaches of these diseases which vary depending on the underlying pathology are given. Although MRI constitutes the diagnostic modality of first choice in suspected spinal vascular malformation, a definite diagnosis of the disease and therefore the choice of suited therapeutic approach rests on selective spinal angiography. Treatment in symptomatic patients offers an improvement in the prognosis. In most spinal vascular malformations, the endovascular approach is the method of first choice; in selected cases, a combined or surgical therapy may be considered.
Division of Neuroradiology, Department of Medical Imaging, University of Toronto, Toronto Western Hospital, Toronto, Ontario, Canada. timo.krings@uhn.on.ca
Timo
T
Krings
Armin K
AK
Thron
Sasikhan
S
Geibprasert
Ronit
R
Agid
Franz J
FJ
Hans
Pierre L
PL
Lasjaunias
Marcus H T
MH
Reinges
D000818:Animals; D001164:Arteriovenous Fistula / Q000145:classification / Q000601:surgery; D020785:Central Nervous System Vascular Malformations / Q000145:classification / Q000473:pathology / Q000601:surgery*; D006801:Humans; D019635:Neurosurgical Procedures; D012039:Regional Blood Flow / Q000502:physiology; D013122:Spinal Diseases / Q000473:pathology / Q000601:surgery*; D013131:Spine / Q000033:anatomy & histology / Q000098:blood supply* / Q000473:pathology