Spinal Vascular Malformations

Abnormal vascular structures developing in the spinal cord and spinal canal (abnormal vascular tangles, fistulas, cavernous lesions).

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Vascular and Endovascular Neurosurgery

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1Overview

Quick and clear information for patients

What is this Condition?

Spinal vascular malformations are abnormal vascular structures in the spinal cord and spinal canal and are rare. Multiple types exist: the most common is an abnormal connection between an artery and vein in the spinal dura mater (spinal dural AV fistula); this type increases venous pressure and causes slowly progressive cord damage (myelopathy). Another group comprises abnormal vascular tangles within the spinal cord (intramedullary AVM) that carry hemorrhage risk. Other types include cavernous lesions that may cause recurrent small hemorrhages. Symptoms vary by type: from slowly progressive leg weakness and urinary/bowel dysfunction to acute back pain and paralysis. Timely diagnosis and treatment help prevent permanent damage; delayed treatment may result in permanent paralysis.

Symptoms

Progressive leg weakness developing over weeks to months (typical in fistula type)

Numbness, paresthesias, and sensory changes at a specific level

Urinary and bowel control problems (retention, incontinence, straining)

Gait difficulty, imbalance; worsening with exertion or straining

In vascular tangle type: sudden severe back pain and acute leg paralysis (sign of hemorrhage)

Lower back and leg pain

Diagnosis Methods

Initial evaluation uses contrast-enhanced MRI of the entire spine; it shows cord edema, abnormally enlarged vessels, and signs of hemorrhage if present. The gold standard for definitive evaluation is catheter-based spinal angiography (DSA); it shows the exact location of abnormal connections or vascular tangles, feeding and draining vessels, and whether the main spinal cord arterial supply can be preserved. This information is critical for treatment planning. CT myelography can be used when MRI is contraindicated.

Treatment Methods

Treatment is determined by malformation type, location, and symptom severity. For the most common spinal dural fistula, treatment is based on surgical closure of the abnormal connection (fistula ligation); this method achieves complete closure in most patients, and patients with early diagnosis often show significant neurological improvement. Endovascular embolization is an option in selected cases. For intramedullary vascular tangles (AVM), microsurgical resection is performed, sometimes preceded by endovascular volume reduction; for small and deep lesions, radiosurgery is an option. Cavernous lesions causing recurrent hemorrhage or progressive damage warrant surgical resection. Early treatment and subsequent rehabilitation are important for functional preservation.

Surgical closure of abnormal connection in spinal dural fistula (fistula ligation)

Microsurgical resection of intramedullary vascular tangle, with preceding endovascular reduction if needed

Radiosurgery for small and deep vascular tangles

Surgical resection for cavernous lesions causing recurrent hemorrhage

Treatment Path

Related Treatments

The procedures and interventions most commonly explored with this condition.

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Servikal spinal intramedüller tümör çıkarılması

Servikal spinal intramedüller tümör çıkarılması procedure

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Servikal spinal ekstramedüller tümör çıkarılması

Servikal spinal ekstramedüller tümör çıkarılması procedure

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Torakal spinal intramedüller tümör çıkarılması

Torakal spinal intramedüller tümör çıkarılması procedure

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Torakal spinal ekstramedüller tümör çıkarılması

Torakal spinal ekstramedüller tümör çıkarılması procedure

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References

Greenberg MS. Handbook of Neurosurgery. 10th ed. Thieme; 2023.
Winn HR, ed. Youmans and Winn Neurological Surgery. 6th ed. Elsevier; 2011.
Spetzler RF, Kalani MYS, Nakaji P, eds. Neurovascular Surgery. 2nd ed. Thieme; 2015.

This content is for informational purposes and based on academic sources; consult your physician for diagnosis and treatment.

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Spinal Vascular Malformations

Vascular and Endovascular Neurosurgery

1Overview

What is this Condition?

Symptoms

Diagnosis Methods

Treatment Methods

Related Treatments

Servikal spinal intramedüller tümör çıkarılması

Servikal spinal ekstramedüller tümör çıkarılması

Torakal spinal intramedüller tümör çıkarılması

Torakal spinal ekstramedüller tümör çıkarılması

References

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Servikal spinal intramedüller tümör çıkarılması

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