McLaughlin Matthew, Green Michael
The Children's Mercy Hospital, Kansas City, MO, USA.
Primary Children's Medical Center, Salt Lake City, UT, USA.
J Pediatr Rehabil Med. 2015;8(3):247-50. doi: 10.3233/PRM-150333.
Describe the case of a spinal arteriovenous malformation (AVM), which represents a rare cause for tetraplegia in the infant population.
This patient underwent treatment with surgical clipping of an intradural AVM, intravenous steroids, and inpatient rehabilitation.
Although AVMs are a congenital vascular malformation, spinal AVMs are extremely rare with only a few case reports published in the pediatric literature. Generally AVMs are diagnosed intracranially which would lead to cerebral infarction; however, in this case, the AVM was in the cervical spinal cord leading to tetraplegia. With medical and rehabilitation interventions, the patient's function improved significantly; however, long-term prognostication remained difficult given the lack of standardized assessments and the inaccuracy of the American Spinal Injury Association (ASIA) examination for this age group.
Spinal AVMs are extremely rare in the pediatric population; however, with this case the use of surgical intervention helped prevent further loss of neurologic impairment, and inpatient rehabilitation served to increase the patient's function. She continued to participate in outpatient rehabilitation to improve developmental milestones, mobility, posture, positioning, and upper limb function.
描述一例脊髓动静脉畸形（AVM）病例，这是婴儿四肢瘫痪的罕见病因。
该患者接受了硬脊膜内AVM手术夹闭、静脉注射类固醇及住院康复治疗。
尽管AVM是一种先天性血管畸形，但脊髓AVM极为罕见，儿科文献中仅有少数病例报告。一般来说，AVM在颅内被诊断出来会导致脑梗死；然而，在本病例中，AVM位于颈脊髓导致四肢瘫痪。通过医学和康复干预，患者功能显著改善；然而，鉴于缺乏标准化评估以及美国脊髓损伤协会（ASIA）对该年龄组检查的不准确性，长期预后仍很困难。
脊髓AVM在儿科人群中极为罕见；然而，通过本病例，手术干预的使用有助于防止神经功能进一步受损，住院康复有助于提高患者功能。她继续参加门诊康复以改善发育里程碑、活动能力、姿势、体位及上肢功能。
