Spinal arteriovenous metameric syndrome in a neonate presenting with congestive heart failure: case report.
BACKGROUND
Spinal arteriovenous metameric syndrome (SAMS) is a combination of more than two separate vascular malformations in the same embryonic metameres. This syndrome, also known as Cobb syndrome, is rare, especially in the neonate.


METHODS
A neonatal girl with a birthmark in the occipital and posterior nuchal regions presented with severe heart failure on the day of birth. The large arteriovenous fistulas in the left hypoglossal canal and in the posterior nuchal region were embolized with detachable coils on the postnatal days 5 and 18, which improved heart failure markedly. The associated intramuscular arteriovenous malformation in the posterior neck was left untreated because large arteriovenous fistulas had been occluded. She grew up without any neurological deficits and developed with normal milestones until the latest follow-up of 8 years old.


CONCLUSIONS
To our knowledge, this is the first case with SAMS in a neonate presenting with congestive heart failure. Presence of a birthmark in a neonate presenting with congestive heart failure may suggest the possible underlying high-flow vascular malformations in the same metamere.
Department of Neuro-Intervention, Osaka City General Hospital, 2-13-22, Miyakojima-Hondori, Miyakojima, Osaka, 534-0021, Japan, komiyama@japan-mail.com.
Masaki
M
Komiyama
Tomoya
T
Ishiguro
Aiko
A
Terada
Yusuke
Y
Watanabe
Hideki
H
Nakajima
Yuuki
Y
Ohata
Yasuhiro
Y
Matsusaka
D001165:Arteriovenous Malformations / Q000150:complications* / Q000628:therapy*; D020785:Central Nervous System Vascular Malformations / Q000150:complications*; D005260:Female; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D007231:Infant, Newborn; D008137:Longitudinal Studies; D015898:Tomography Scanners, X-Ray Computed