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Titolo:
Venous congestion is a major cause of neurological deterioration in spinalarteriovenous malformations
Autore:
Kataoka, H; Miyamoto, S; Nagata, I; Ueba, T; Hashimoto, N;
Indirizzi:
Kyoto Univ, Grad Sch Med, Dept Neurosurg, Sakyo Ku, Kyoto 6068507, Japan Kyoto Univ Kyoto Japan 6068507 Neurosurg, Sakyo Ku, Kyoto 6068507, Japan Natl Cardiovasc Ctr, Dept Neurosurg, Osaka, Japan Natl Cardiovasc Ctr Osaka Japan ovasc Ctr, Dept Neurosurg, Osaka, Japan
Titolo Testata:
NEUROSURGERY
fascicolo: 6, volume: 48, anno: 2001,
pagine: 1224 - 1229
SICI:
0148-396X(200106)48:6<1224:VCIAMC>2.0.ZU;2-U
Fonte:
ISI
Lingua:
ENG
Soggetto:
CLINICAL-FEATURES; VASCULAR MALFORMATIONS; MEDULLARY VEINS; CORD; FISTULAS; MR; MYELOPATHY; INFARCTION; DIAGNOSIS; ANGIOMAS;
Keywords:
myelopathy; spinal arteriovenous malformation; spinal cord; venous congestion;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
25
Recensione:
Indirizzi per estratti:
Indirizzo: Miyamoto, S Kyoto Univ, Grad Sch Med, Dept Neurosurg, Sakyo Ku, 54 Kawahara Cho, Kyoto6068507, Japan Kyoto Univ 54 Kawahara Cho Kyoto Japan 6068507 6068507, Japan
Citazione:
H. Kataoka et al., "Venous congestion is a major cause of neurological deterioration in spinalarteriovenous malformations", NEUROSURGER, 48(6), 2001, pp. 1224-1229

Abstract

OBJECTIVE: Although venous congestion is considered to be a major cause ofprogressive myelopathy in patients with spinal dural arteriovenous fistulae (DAVFs), the neurological deterioration in patients with spinal intradural arteriovenous malformations (AVMs) has been attributed to hemorrhage or to vascular steal. To reexamine this theory, we analyzed our own cases of spinal vascular diseases. METHODS: In 24 patients with spinal vascular diseases, those who demonstrated progressive myelopathy with T2 hyperintensity in the spinal cord on magnetic resonance imaging (MRI) were diagnosed as patients with congestive myelopathy. We further examined the clinical courses, MRI findings, and reversibility of these cases. RESULTS: Venous congestion was judged to be a cause of neurological deterioration in 13 patients (7 DAVFs, 6 intradural AVMs). The T2 signals on these patients' MRI scans were located in the center and extended over several levels not corresponding to distribution of ischemia due to arterial steal. Of the patients who were diagnosed with congestive myelopathy, no differences between those with DAVFs and those with intradural AVMs were apparent in terms of clinical manifestations and reversibility. Eight (four DAVFs, four intradural AVMs) of 13 patients experienced neurological improvement after treatment. All patients with poor outcomes had intervals from onset of more than 3 years and showed contrast enhancement of the spinal cord on MRI studies. CONCLUSION: Spinal intradural AVMs as well as spinal DAVFs can be a cause of venous congestive myelopathy. Regardless of its etiology, congestive myelopathy is potentially reversible if properly diagnosed and treated.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 15/07/20 alle ore 18:57:06