Chun Jay Y, Gulati Mittul, Halbach Van, Lawton Michael T
Department of Neurological Surgery, University of California at San Francisco, San Francisco, California 94143-0112, USA.
Surg Neurol. 2004 Jan;61(1):92-4. doi: 10.1016/s0090-3019(03)00304-5.
Thrombosis of cerebral arteriovenous malformations (AVM) and spinal dural arteriovenous fistulas following hemorrhage rarely have been reported. Rarer still is thrombosis of spinal AVMs following hemorrhage.
A 6-year-old boy presented with sudden low back and sciatic pain, bilateral leg weakness, and an intramedullary spinal cord hematoma. Spinal angiography demonstrated dilated feeding arteries without shunting, and no intervention was performed. Over time, these enlarged arteries reduced in caliber, and the patient recovered fully.
The rarity of spinal AVMs and AVM thrombosis make their coincidence in this case unique. Although surgical intervention would have enabled definitive diagnosis of the spinal AVM, it is not mandatory in the absence of arteriovenous shunting. What is mandatory, however, is continued angiographic surveillance, particularly in pediatric patients.
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