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Titolo:
Posterior approach for cervical intramedullary arteriovenous malformation with diffuse-type nidus - Report of three cases
Autore:
Ohata, K; Takami, T; El-Naggar, A; Morino, M; Nishio, A; Inoue, Y; Hakuba, A;
Indirizzi:
Osaka City Univ, Sch Med, Dept Neurosurg, Abeno Ku, Osaka 5458586, Japan Osaka City Univ Osaka Japan 5458586 surg, Abeno Ku, Osaka 5458586, Japan Osaka City Univ, Sch Med, Dept Radiol, Abeno Ku, Osaka 5458586, Japan Osaka City Univ Osaka Japan 5458586 diol, Abeno Ku, Osaka 5458586, Japan
Titolo Testata:
JOURNAL OF NEUROSURGERY
fascicolo: 1, volume: 91, anno: 1999, supplemento:, S
pagine: 105 - 111
SICI:
0022-3085(199907)91:1<105:PAFCIA>2.0.ZU;2-4
Fonte:
ISI
Lingua:
ENG
Soggetto:
ANTERIOR SPINAL ARTERY; VASCULAR MALFORMATIONS; EMBOLIZATION; CORD; AVMS;
Keywords:
arteriovenous malformation; cervical spine; diffuse-type nidus; intramedullary lesion; juvenile-type nidus; surgical approach;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
37
Recensione:
Indirizzi per estratti:
Indirizzo: Ohata, K Osaka City Univ, Sch Med, Dept Neurosurg, Abeno Ku, 1-5-7 Asahi Machi, Osaka 5458586, Japan Osaka City Univ 1-5-7 Asahi Machi Osaka Japan 5458586 586, Japan
Citazione:
K. Ohata et al., "Posterior approach for cervical intramedullary arteriovenous malformation with diffuse-type nidus - Report of three cases", J NEUROSURG, 91(1), 1999, pp. 105-111

Abstract

The treatment of spinal intramedullary arteriovenous malformations (AVMs) with a diffuse-type nidus that contains a neural element poses different challenges compared with a glomus-type nidus. The surgical elimination of such lesions involves the risk of spinal cord ischemia that results from coagulation of the feeding artery that, at the same time, supplies cord parenchyma. However, based on evaluation of the risks involved in performing embolization, together with the frequent occurrence of reperfusion, which necessitates frequent reembolization, the authors consider surgery to be a one-stage solution to a disease that otherwise has a very poor prognosis. Magnetic resonance (MR) imaging revealed diffuse-type intramedullary AVMs in the cervical spinal cords of three patients who subsequently underwent surgery via the posterior approach. The AVM was supplied by the anterior spinal artery in one case and by both the anterior and posterior spinal arteries in the other two cases. In all three cases, a posterior median myelotomywas performed up to the vicinity of the anterior median fissure that divided the spinal cord together with the nidus, and the feeding artery was coagulated and severed at its origin from the anterior spinal artery. In the two cases in which the posterior spinal artery fed the AVM, the feeding artery was coagulated on the dorsal surface of the spinal cord. Neurological outcome improved in one patient and deteriorated slightly to mildly in the other two patients. Postoperative angiography demonstrated complete disappearance of the AVM in all cases. Because of the extremely poor prognosis of patients with spinal intramedullary AVMs, this surgical technique for the treatment of diffuse-type AVMs provides acceptable operative outcome. Surgical intervention should be considered when managing a patient with a diffuse-type intramedullary AVM in thecervical spinal cord.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/11/20 alle ore 05:56:04