title: [Diagnostic work-up and therapy of spinal vascular malformations: an update].
abstract: BACKGROUND
  Spinal vascular malformations are rare disease patterns with a clinical incidence of about 5-10/year/1 million comprising spinal arteriovenous malformations (sAVM), spinal arteriovenous fistulas (sAVF) and spinal cavernomas. Long courses of disease before diagnosis deteriorate the prognosis despite successful treatment.
  
  
  METHODS
  Selective review of the literature in consideration of present guidelines.
  
  
  RESULTS
  Spinal vascular pathological conditions can be classified into different subtypes especially by use of magnetic resonance imaging (MRI) and selective digital subtraction angiography (DSA). Diagnosis and treatment of spinal dural arteriovenous fistula (type I) as well as spinal arteriovenous malformations (type II-V) ideally require a close co-operation between neurosurgeons and neuroradiologists. Surgery can in general be considered as curative. Endovascular therapy of arteriovenous malformations results in reduction of size and concomitant haemodynamic effects. A curative approach is generally not possible. Particularly in cases of lumbosacral and craniosacral arteriovenous fistulas the interventional procedure provides advantages. Treatment of spinal cavernomas nowadays consists of neurosurgical approaches exclusively. The significance of radiosurgical therapy, especially with the CyberKnife, remains indistinct. Today, interdisciplinary neurosurgical and neuroradiological co-operation in specialized centres allows most spinal vascular malformations to be diagnosed at an early stage and to be treated with satisfying results.
authors.affiliation: Klinik für Neurochirurgie, Heinrich-Heine-Universität, Moorenstrasse 5, Düsseldorf, Germany. Sven.Eicker@med.uni-duesseldorf.de
authors.forename: S
authors.initials: S
authors.lastname: Eicker
authors.forename: B
authors.initials: B
authors.lastname: Turowski
authors.forename: H-J
authors.initials: HJ
authors.lastname: Steiger
authors.forename: D
authors.initials: D
authors.lastname: Hänggi
mesh_terms: D000328:Adult; D015901:Angiography, Digital Subtraction; D020785:Central Nervous System Vascular Malformations / Q000175:diagnosis* / Q000628:therapy; D002648:Child; D004621:Embolization, Therapeutic; D005260:Female; D020786:Hemangioma, Cavernous, Central Nervous System / Q000628:therapy; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D010348:Patient Care Team; D017410:Practice Guidelines as Topic; D011379:Prognosis; D016634:Radiosurgery; D013116:Spinal Cord / Q000098:blood supply*; D013120:Spinal Cord Neoplasms / Q000175:diagnosis / Q000628:therapy; D016896:Treatment Outcome; D055815:Young Adult
references.citation: Neuroradiology. 1977 Jun 27;13(4):181-9
references.pmid: 876450
references.citation: Neurosurgery. 1999 Feb;44(2):428
references.pmid: 9932908
references.citation: Acta Neurochir (Wien). 1999;141(3):237-45
references.pmid: 10214479
references.citation: Acta Neurochir Suppl. 2005;94:115-22
references.pmid: 16060250
references.citation: Neurosurgery. 1993 Dec;33(6):972-9; discussion 979-80
references.pmid: 8134010
references.citation: No To Shinkei. 1995 Aug;47(8):783-7
references.pmid: 7546925
references.citation: Br J Neurosurg. 1997 Aug;11(4):298-305
references.pmid: 9337927
references.citation: Neurol Med Chir (Tokyo). 2003 Oct;43(10):471-5; discussion 476
references.pmid: 14620197
references.citation: J Neurosurg. 1993 Mar;78(3):446-51
references.pmid: 8433147
references.citation: J Neurosurg. 1984 Feb;60(2):238-47
references.pmid: 6693950
references.citation: Surg Neurol. 2008 Aug;70(2):176-81; discussion 181
references.pmid: 18207494
references.citation: J Neurosurg Spine. 2007 Nov;7(5):478-85
references.pmid: 17977188
references.citation: Radiologe. 2001 Nov;41(11):955-60
references.pmid: 11765536
references.citation: Neurosurgery. 2008 Jan;62(1):159-66; discussion 166-7
references.pmid: 18300903
references.citation: J Neurosurg. 2002 Mar;96(2 Suppl):145-56
references.pmid: 12450276
references.citation: Neuroimaging Clin N Am. 2007 Feb;17(1):57-72
references.pmid: 17493539
references.citation: Neurosurg Rev. 2004 Apr;27(2):93-8
references.pmid: 14714194
references.citation: Ideggyogy Sz. 2003 Mar 20;56(3-4):115-8
references.pmid: 12712884
references.citation: Neurosurgery. 1993 Jun;32(6):885-91; discussion 891
references.pmid: 8327088
references.citation: Br J Radiol. 1959 Dec;32:810-4
references.pmid: 14418059
references.citation: J Neurosurg Spine. 2009 May;10(5):423-9
references.pmid: 19442003
references.citation: Neurosurgery. 2004 Jul;55(1):77-87; discussion 87-8
references.pmid: 15214976
references.citation: Neuroradiology. 2008 Oct;50(10):869-76
references.pmid: 18587568
references.citation: J Neurosurg. 2006 Mar;104(3):376-81
references.pmid: 16572649
references.citation: Eur Spine J. 1997;6(5):298-303
references.pmid: 9391798
references.citation: AJNR Am J Neuroradiol. 1992 May-Jun;13(3):913-22
references.pmid: 1590191