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Spinal cord arteriovenous shunts of the ventral (anterior) sulcus: anatomical, clinical, and therapeutic considerations
L. Roccatagliata, S. Kominami, A. Krajina, R. Sellar, M. Soderman, R. Van den Berg, H. Desal, S. Condette-Auliac, G. Rodesch,
Language English Country Germany
Document type Journal Article
NLK
ProQuest Central
from 2002-01-01 to 1 year ago
CINAHL Plus with Full Text (EBSCOhost)
from 2008-01-01 to 1 year ago
Medline Complete (EBSCOhost)
from 2003-01-01 to 1 year ago
Nursing & Allied Health Database (ProQuest)
from 2002-01-01 to 1 year ago
Health & Medicine (ProQuest)
from 2002-01-01 to 1 year ago
- MeSH
- Arteriovenous Malformations diagnostic imaging therapy MeSH
- Adult MeSH
- Contrast Media MeSH
- Humans MeSH
- Magnetic Resonance Angiography MeSH
- Magnetic Resonance Imaging methods MeSH
- Spinal Cord blood supply MeSH
- Retrospective Studies MeSH
- Embolization, Therapeutic methods MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
INTRODUCTION: Ventral sulcus spinal cord arteriovenous shunts (SCAVS) are rare vascular lesions that are located outside the spinal cord, are exclusively vascularized by the anterior spinal axis, and drain exclusively through the anterior spinal vein. We report the anatomical, clinical, and neuro-radiological features of SCAVS managed by our team. METHODS: We conducted a retrospective study of patients with SCAVSs evaluated by the senior author of this report (GR) between 1981 and 2014. Data were collected by reviewing clinical notes and by a systematic analysis of spinal angiograms and MRI. RESULTS: Among 358 patients, we identified 8 patients (3 women) with ventral sulcus spinal cord arteriovenous shunts. Mean age was 30.5 years. Six patients presented with progressive neurological symptoms, and two with acute neurological symptoms related to hematomyelia. Three shunts were located in the cervical cord, four in the thoracic cord, and one at the conus medullaris; there were two nidus type A-V shunts (AVMs) and six fistula type A-V shunts (AVFs). Seven patients were treated by endovascular therapy with glue embolization. Embolization led to anatomical cure in 5 cases, and a significant reduction of shunt volume and flow of more than 75% in 2 cases. In none of the cases we observed permanent morbidity. CONCLUSIONS: AVS of the ventral sulcus of the spinal cord are rare. Recognition of these lesions and precise localization of the anatomical space in which they are located, may allow a better understanding of their pathophysiology and clinical manifestations and guide proper therapeutic decisions.
Center for Clinical Brain Sciences University of Edinburgh Edinburgh UK
Department of Neuroradiology Karolinska University Hospital Stockholm Sweden
Department of Neuroradiology University of Nantes Medical Center Nantes France
Department of Neurosurgery Chiba Hokuso Hospital Nippon Medical School Chiba Japan
Department of Radiology AMC Amsterdam The Netherlands
Department of Radiology Faculty Hospital Hradec Kralove Czech Republic
References provided by Crossref.org
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- $a Roccatagliata, Luca $u Service de Neuroradiologie Diagnostique et Thérapeutique, Hôpital Foch, 40 rue Worth, 92150, Suresnes, France. Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
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- $a INTRODUCTION: Ventral sulcus spinal cord arteriovenous shunts (SCAVS) are rare vascular lesions that are located outside the spinal cord, are exclusively vascularized by the anterior spinal axis, and drain exclusively through the anterior spinal vein. We report the anatomical, clinical, and neuro-radiological features of SCAVS managed by our team. METHODS: We conducted a retrospective study of patients with SCAVSs evaluated by the senior author of this report (GR) between 1981 and 2014. Data were collected by reviewing clinical notes and by a systematic analysis of spinal angiograms and MRI. RESULTS: Among 358 patients, we identified 8 patients (3 women) with ventral sulcus spinal cord arteriovenous shunts. Mean age was 30.5 years. Six patients presented with progressive neurological symptoms, and two with acute neurological symptoms related to hematomyelia. Three shunts were located in the cervical cord, four in the thoracic cord, and one at the conus medullaris; there were two nidus type A-V shunts (AVMs) and six fistula type A-V shunts (AVFs). Seven patients were treated by endovascular therapy with glue embolization. Embolization led to anatomical cure in 5 cases, and a significant reduction of shunt volume and flow of more than 75% in 2 cases. In none of the cases we observed permanent morbidity. CONCLUSIONS: AVS of the ventral sulcus of the spinal cord are rare. Recognition of these lesions and precise localization of the anatomical space in which they are located, may allow a better understanding of their pathophysiology and clinical manifestations and guide proper therapeutic decisions.
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