Surgical neuroangiography of the spine and spinal cord

The SCAVMs are high-flow lesions that present at a younger age, during the second or third decades of life. The most common presenting symptoms are subarachnoid hemorrhage and hematomyelia. Endovascular treatment of these lesions has become an important adjunct to surgical management. Complete occlusion is possible by superselective catheterizations and injection of a liquid embolic material. The SDAVFs are slow-flow AV shunting at the dura, which causes progressive neurologic deficit in older age--the fifth or sixth decades of life. Embolization is now the primary mode of treatment. Preoperative embolization of the hypervascular tumors of the spine and spinal cord has become a necessity to reduce bleeding during surgery, and it even reduces the size of the tumor and relieves spinal block. Thorough knowledge of vascular anatomy and better understanding of hemodynamics of these lesions are essential to perform proper and safe embolization.