Consoli Arturo, Smajda Stanislas, Trenkler Johannes, Söderman Michael, Rodesch Georges
Diagnostic and Interventional Neuroradiology Department, Foch Hospital, 40 rue Worth, 92150, Suresnes, France.
Department of Interventional Neuroradiology, Fondation Rothschild Hospital, Paris, France.
Childs Nerv Syst. 2019 Jun;35(6):945-955. doi: 10.1007/s00381-019-04108-0. Epub 2019 Mar 7.
Intradural spinal cord arteriovenous shunts represent a rare entity, particularly in the pediatric population, and clinical diagnosis can be challenging.
We report the analysis of clinical, angioarchitectural, procedural, and follow-up data in a population of 36 children managed by our team between 2002 and 2017.
Hemorrhage occurred in 26 children (72%). Age at onset was 9.22 ± 3.65 years. Lesions were located at the thoracic level in 16 cases, at the cervical level in 15 cases, and the thoraco-lumbar region in 5 cases. A genetic or metameric syndrome was associated in 18 children (50%). Glue embolization provided complete occlusion in 5 children, subtotal in 7, and extensive in 14 without intraprocedural complications. We observed clinical normalization in 11 children, improvement in 11 cases, and stability in 3. Four children worsened during the follow-up, and one child died.
Endovascular staged glue embolization performed in experienced centers is safe in the treatment of pediatric intradural spinal cord arteriovenous shunts. Clinical and neuroradiological follow-up is mandatory, especially for pediatric patients.
硬脊膜内脊髓动静脉分流是一种罕见疾病，在儿科人群中尤为如此，临床诊断具有挑战性。
我们报告了对2002年至2017年间由我们团队治疗的36名儿童的临床、血管构筑、手术及随访数据的分析。
26名儿童（72%）发生出血。发病年龄为9.22±3.65岁。病变位于胸段16例，颈段15例，胸腰段5例。18名儿童（50%）伴有遗传或节段性综合征。胶水栓塞使5名儿童完全闭塞，7名部分闭塞，14名广泛闭塞，术中无并发症。我们观察到11名儿童临床症状恢复正常，11例改善，3例稳定。4名儿童在随访期间病情恶化，1名儿童死亡。
在经验丰富的中心进行的血管内分期胶水栓塞治疗小儿硬脊膜内脊髓动静脉分流是安全的。必须进行临床和神经放射学随访，尤其是对儿科患者。
