Cobb syndrome: case report

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Ignacio Pascual-Castroviejo1, Remedios Frutos, Juan Viaño

  • 1Pediatric Neurology Service, University Hospital La Paz, Madrid, Spain. pascas@inves.es

Journal of Child Neurology
|February 15, 2003
PubMed

Insights

A rare case of a 7-year-old boy showed associated cutaneous hemangioma and spinal arteriovenous malformations. Both spinal and paraspinal malformations were found to originate from the same intercostal arteries.

Area of Science:

  • Vascular malformations
  • Pediatric neurology
  • Radiology

Background:

  • Arteriovenous malformations (AVMs) are complex vascular anomalies.
  • Spinal AVMs can present with varied clinical manifestations.
  • Co-occurrence of cutaneous and spinal vascular malformations is uncommon.

Observation:

  • A 7-year-old boy presented with a cutaneous hemangioma.
  • Physical examination revealed subtle cutaneous changes on the back, requiring tactile stimulation for detection.
  • Magnetic resonance arteriography (MRA) identified both intramedullary and paraspinal arteriovenous malformations.

Findings:

  • Selective intercostal arteriography confirmed that the intraspinal and paraspinal AVMs shared common feeding intercostal arteries.
  • This finding suggests a potential shared vascular supply pathway for these distinct malformations.
  • The cutaneous hemangioma's association with the spinal AVMs was noted.

Implications:

  • Highlights the importance of thorough vascular imaging in pediatric patients with suspected spinal abnormalities.
  • Suggests a possible syndromic association or shared developmental origin for combined cutaneous and spinal AVMs.
  • Informs diagnostic and therapeutic strategies for complex vascular malformations in children.

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