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节段性脊髓动静脉畸形:通过栓塞硬膜外成分实现长期症状缓解。

Metameric spinal AVM: Long-term symptomatic relief achieved by embolization of the extradural component.

作者信息

Drake B, Patro S, Quateen A, Cora E A, Finitsis S, Sinclair J, Lesiuk H, Iancu D

机构信息

1 University of Ottawa, Ottawa, Canada.

2 Hamad General Hospital, Neuroscience Al Sadd, Doha, Qatar.

出版信息

Interv Neuroradiol. 2019 Aug;25(4):469-473. doi: 10.1177/1591019919828135. Epub 2019 Mar 28.

DOI:10.1177/1591019919828135
PMID:30922201
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6607622/
Abstract

BACKGROUND

Metameric spinal cord arteriovenous malformations (AVMs) are rare lesions characterized by an intradural and extradural component. They are difficult to treat surgically by the endovascular route. We report a case in which symptomatic relief was achieved by embolization of the extradural component only.

CASE PRESENTATION

A 35-year-old woman presented with acute worsening of back pain, weakness in the left leg and urinary retention. Spinal angiography showed a metameric spinal cord AVM with partial common venous drainage of the extradural and intradural components.

CONCLUSIONS

Targeted embolization of the extradural component led to dramatic improvement of the patient's symptoms, probably by achieving venous decongestion. She remains neurologically stable at two years' follow-up.

摘要

背景

节段性脊髓动静脉畸形(AVM)是罕见的病变,其特征为硬膜内和硬膜外成分。通过血管内途径进行手术治疗很困难。我们报告了一例仅通过栓塞硬膜外成分而实现症状缓解的病例。

病例介绍

一名35岁女性因背痛急性加重、左腿无力和尿潴留就诊。脊髓血管造影显示为节段性脊髓AVM,硬膜外和硬膜内成分部分共同静脉引流。

结论

硬膜外成分的靶向栓塞导致患者症状显著改善,可能是通过实现静脉充血缓解。在两年的随访中,她的神经功能保持稳定。

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本文引用的文献

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Spine J. 2015 Mar 1;15(3):e15-22. doi: 10.1016/j.spinee.2014.11.022. Epub 2014 Nov 29.
2
Spinal arteriovenous metameric syndrome: clinical manifestations and endovascular management.脊髓动静脉分节综合征:临床表现与血管内治疗。
AJNR Am J Neuroradiol. 2013 Feb;34(2):457-63. doi: 10.3174/ajnr.A3212. Epub 2012 Aug 2.
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Obliteration of a metameric spinal arteriovenous malformation (Cobb syndrome) using combined endovascular embolization and surgical excision.采用血管内栓塞联合手术切除治疗节段性脊髓动静脉畸形(科布综合征)
J Neurosurg Pediatr. 2012 Jul;10(1):44-9. doi: 10.3171/2012.3.PEDS11530. Epub 2012 Jun 15.
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