Paraspinal arteriovenous malformations in children.

Area of Science:

• Vascular Surgery
• Pediatric Neurosurgery
• Interventional Radiology

Background:

• Paraspinal arteriovenous malformations (AVMs) are uncommon vascular anomalies.
• While spinal cord and dural AVMs are frequently reported, paraspinal AVMs causing spinal venous congestion or hemorrhage are rare, posing diagnostic and management challenges.

Observation:

• This study reviews 16 previously reported cases of pediatric paraspinal AVMs.
• A 17th case is presented, involving a child with a paraspinal AVM who experienced a spontaneous spinal epidural hematoma, a previously undocumented association.
• The authors note this is the first reported instance of a spinal epidural hematoma linked to a paraspinal AVM.

Findings:

• All 17 pediatric cases of paraspinal AVMs were successfully treated.
• Endovascular therapy, specifically embolization with permanent occlusive agents, proved effective in obliterating the vascular lesions.

Implications:

• Paraspinal AVMs, though rare, require specialized diagnostic and management approaches.
• Endovascular embolization is a highly effective treatment modality for these potentially debilitating lesions.
• The findings highlight the importance of considering paraspinal AVMs in the differential diagnosis of spinal epidural hematomas in pediatric patients.