Targeted embolisation for coexisting conus medullaris arteriovenous malformation and cauda equina arteriovenous fistulas with a varix on a shared drainer
Multiple arteriovenous malformations
conus arterial basket
radicular arteriovenous fistula
Journal
British journal of neurosurgery
ISSN: 1360-046X
Titre abrégé: Br J Neurosurg
Pays: England
ID NLM: 8800054
Informations de publication
Date de publication:
Oct 2023
Oct 2023
Historique:
medline:
23
10
2023
pubmed:
10
10
2020
entrez:
9
10
2020
Statut:
ppublish
Résumé
The coexistence of vascular malformations in the conus medullaris and cauda equina has been rarely reported, and the complex angioarchitecture in multiple arteriovenous lesions remains poorly understood. A 17-year-old woman presented with a sudden-onset, stepwise worsening of weakness and pain in the bilateral legs. Angiography revealed conus medullaris arteriovenous malformation and cauda equina arteriovenous fistulas. One of the drainers was shared between the coexisting lesions and harboured a varix. Targeted embolisation of a fistulous point in the conus lesion was performed with precaution to prevent occluding the common drainage route, which led to symptom improvement with angiographical diminishment of the varix. Recognising that communications between drainers can be observed in multiple spinal arteriovenous lesions is important in facilitating a safe embolisation. Cautious assessment of angiogram with fusion images of cone-beam computed tomography and volumetric T2 magnetic resonance imaging can help in establishing the diagnosis and treatment strategy.
Sections du résumé
BACKGROUND
UNASSIGNED
The coexistence of vascular malformations in the conus medullaris and cauda equina has been rarely reported, and the complex angioarchitecture in multiple arteriovenous lesions remains poorly understood.
CASE DESCRIPTION
UNASSIGNED
A 17-year-old woman presented with a sudden-onset, stepwise worsening of weakness and pain in the bilateral legs. Angiography revealed conus medullaris arteriovenous malformation and cauda equina arteriovenous fistulas. One of the drainers was shared between the coexisting lesions and harboured a varix. Targeted embolisation of a fistulous point in the conus lesion was performed with precaution to prevent occluding the common drainage route, which led to symptom improvement with angiographical diminishment of the varix.
CONCLUSIONS
UNASSIGNED
Recognising that communications between drainers can be observed in multiple spinal arteriovenous lesions is important in facilitating a safe embolisation. Cautious assessment of angiogram with fusion images of cone-beam computed tomography and volumetric T2 magnetic resonance imaging can help in establishing the diagnosis and treatment strategy.
Identifiants
pubmed: 33034527
doi: 10.1080/02688697.2020.1830948
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM