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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Clinical presentation and optimal management for intramedullary cavernous malformations
George I Jallo1, Diana Freed, Michelle Zareck
1Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland, USA. gjallo1@jhmi.edu
Neurosurgical Focus
|July 25, 2006
Summary
Spinal intramedullary cavernous malformations (CMs) present with acute or progressive neurological decline. Microsurgery for these lesions can halt symptom progression, offering a positive outcome for patients.
Area of Science:
- Neurosurgery
- Neurology
- Spinal Cord Pathology
Background:
- Intramedullary cavernous malformations (CMs) represent approximately 5% of intraspinal lesions.
- These lesions, though benign, are known for their clinically progressive nature.
Purpose of the Study:
- To delineate the diverse clinical presentations of spinal intramedullary CMs.
- To evaluate the outcomes of microsurgical resection for these spinal cord lesions.
Main Methods:
- Retrospective review of 26 patients with histologically confirmed intramedullary CMs.
- Preoperative magnetic resonance (MR) imaging was utilized for all patients.
- All patients underwent laminectomy and microsurgical resection of the malformation.
Main Results:
- MR imaging demonstrates a characteristic pattern for intramedullary CMs, often abutting a pial surface.
- Presentations range from acute neurological compromise to slowly progressive decline.
- Acute decline is typically due to intramedullary hemorrhage; chronic decline results from microhemorrhages and gliosis.
Conclusions:
- MR imaging is diagnostic for intramedullary CMs.
- Spinal intramedullary CMs present with varied neurological deficits due to hemorrhage or microhemorrhage.
- Surgical total resection of intramedullary CMs is effective in halting disease progression.
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