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Surgical treatment of cryptic AVM's and associated hematoma in the brain stem and spinal cord
Abstract:
Most surgically treated cases of brain-stem hematomas have been attributed to rupture of cryptic arteriovenous malformations (AVM's); however, very few cases have been histologically proven. Similarly, there are very few reports of surgically treated spontaneous hematomyelia, in which the hemorrhage has been histologically confirmed as being due to a purely intramedullary AVM. The authors report three cases with surgically treated, histologically confirmed AVM's, of which two were in the brain stem and the third was in the spinal cord. In all these cases, abnormal vascular tissue in the wall of the hematoma cavity was recognized at operation and excised.
Insights
This study confirms arteriovenous malformations (AVMs) as a cause of brain-stem and spinal cord hematomas. Histological confirmation and surgical excision of these vascular malformations were key in three surgically treated cases.
Area of Science:
- Neurology
- Neurosurgery
- Vascular Malformations
Background:
- Brain-stem hematomas are often linked to arteriovenous malformations (AVMs), but histological proof is rare.
- Spontaneous spinal cord hematomyelia due to intramedullary AVMs is infrequently reported and rarely confirmed histologically.
Observation:
- The study presents three surgically treated cases with histologically confirmed AVMs.
- Two cases involved brain-stem AVMs, and one case involved a spinal cord AVM.
- Abnormal vascular tissue within the hematoma cavity was identified during surgery in all cases.
Findings:
- Histological confirmation of AVMs as the cause of brain-stem and spinal cord hematomas.
- Successful surgical treatment involving the excision of abnormal vascular tissue.
- Demonstration of AVMs in both the brain stem and spinal cord locations.
Implications:
- Highlights the importance of considering and confirming AVMs in cases of unexplained brain-stem and spinal cord hematomas.
- Supports surgical intervention for histologically confirmed AVMs causing intracranial and spinal hemorrhages.
- Contributes to the understanding of the etiology and surgical management of these rare vascular lesions.