[Spinal cord vascular diseases].

Area of Science:

• Neurology
• Vascular Surgery
• Radiology

Background:

• Spinal vascular malformations encompass diverse conditions like spinal dural arteriovenous (AV) fistulas, acquired malformations, and cavernous hemangiomas.
• Spinal AV fistulas involve abnormal connections between dural arteries and superficial perimedullary veins.
• These conditions are rare, often present with misinterpreted symptoms, leading to diagnostic delays exceeding 12 months.

Purpose of the Study:

• To highlight the importance of early diagnosis and treatment of spinal vascular malformations, particularly spinal dural AV fistulas.
• To describe the diagnostic features of spinal dural AV fistulas on magnetic resonance imaging (MRI).
• To outline treatment options for spinal dural AV fistulas and discuss the risks associated with cavernous hemangiomas.

Main Methods:

• Review of clinical presentations and diagnostic findings for spinal vascular malformations.
• Emphasis on magnetic resonance imaging (MRI) characteristics, including intramedullary edema on T2-weighted sequences and dilated superficial veins.
• Discussion of treatment modalities including surgical ligation and embolization.

Main Results:

• Spinal dural AV fistulas can lead to progressive neurological deficits, including paraplegia, if not diagnosed and treated early.
• MRI is instrumental in early detection, revealing characteristic signs of intramedullary edema and venous dilation.
• Cavernous hemangiomas present a low risk of bleeding (0.2-0.5%) but can also cause venous hemorrhage and neurological symptoms.

Conclusions:

• Early diagnosis of spinal vascular malformations, especially spinal dural AV fistulas, is critical to prevent irreversible neurological damage.
• Prompt MRI interpretation and timely intervention (ligation or embolization) are key to successful management.
• Understanding the specific characteristics and risks of different spinal vascular malformations aids in appropriate patient care.