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TRAUMATIC ARTERIOVENOUS COMMUNICATION PRESENTING 36 YEARS AFTER INITIAL INJURY
John M. Keshishian1, Ayub K. Ommaya, David O. Davis
1Departments of Surgery, Neurosurgery, and Radiology of the George Washington University Medical Center, Washington, D.C.
Cardiovascular Diseases
|September 1, 1978
Summary
A rare spinal arteriovenous malformation (AVM) caused progressive neurological deficits in a patient with a history of pelvic fractures. Surgical excision of the AVM led to significant neurological recovery and improved circulation.
Area of Science:
- Neurology
- Vascular Surgery
- Radiology
Background:
- A 59-year-old male presented with progressive neurological deficits after a 36-year history of multiple pelvic fractures.
- Symptoms were indicative of a spinal arteriovenous malformation (AVM).
Purpose of the Study:
- To report a unique case of spinal arteriovenous malformation presenting decades after pelvic trauma.
- To detail the diagnostic and interventional management of this rare condition.
Main Methods:
- Angiographic evaluation to precisely locate the spinal arteriovenous fistula.
- Preliminary temporary obliteration using an intra-arterial catheter balloon.
- Surgical excision of the arteriovenous malformation.
Main Results:
- Successful identification and obliteration of the arteriovenous fistula.
- Immediate improvement in peripheral circulation post-intervention.
- Progressive resolution of neurological deficits following surgical excision.
Conclusions:
- This case represents a potentially novel association between remote pelvic trauma and the late development of spinal arteriovenous malformations.
- Surgical management can be effective in treating such rare vascular lesions, leading to favorable neurological outcomes.