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采用分期血管内治疗和脊柱稳定方法治疗小儿节段性颈脊髓动静脉畸形:一例报告

Pediatric metameric cervical spinal cord arteriovenous malformation managed with staged endovascular and spinal stabilization approach: a case report.

作者信息

Gabay Segev, Hausman-Kedem Moran, Sadeh Gonik Udi, Jonash-Kimchi Tali, Shiran Shelly, Chapot Rene, Roth Jonathan, Lidar Zvi, Ofir Dror

机构信息

Department of Pediatric Neurosurgery and Pediatric Brain Institute, Dana Dwek Children Hospital, Tel Aviv Medical Center, Tel Aviv, Israel.

Department of Neurosurgery, Spine Surgery Unit, Tel Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel.

出版信息

Spinal Cord Ser Cases. 2024 Dec 11;10(1):80. doi: 10.1038/s41394-024-00691-w.

DOI:10.1038/s41394-024-00691-w
PMID:39663383
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11634885/
Abstract

INTRODUCTION

Spinal cord arteriovenous malformations (SCAVM) are rare congenital vascular malformations, characterized by two or more AVMs affecting any of the spinal segments. SCAVM has complex pathophysiology and may be associated with acute, or progressively neurological deficits.

CASE PRESENTATION

A 12-year old girl, presented with progressive neurologic deficits secondary to compressive cervical myelopathy due to a cervical metameric SCAVM. She was successfully treated with a staged surgical-endovascular approach and regained normal neurological function with radiological stability.

DISCUSSION

SCAVM is a rare disease with complex management, and in many cases, the treatment is focused on palliative care. With multimodality management, of a combined surgical-endovascular approach, the patient achieved neurological, functional, and structural stability over the follow-up period.

摘要

引言

脊髓动静脉畸形(SCAVM)是一种罕见的先天性血管畸形,其特征是两个或更多的动静脉畸形影响任何脊髓节段。SCAVM具有复杂的病理生理学,可能与急性或进行性神经功能缺损有关。

病例介绍

一名12岁女孩,因颈椎节段性SCAVM导致压迫性颈髓病继发进行性神经功能缺损。她通过分期手术-血管内治疗方法成功治疗,并在影像学稳定的情况下恢复了正常神经功能。

讨论

SCAVM是一种罕见疾病,治疗复杂,在许多情况下,治疗侧重于姑息治疗。通过手术-血管内联合的多模式管理,患者在随访期间实现了神经、功能和结构的稳定。

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本文引用的文献

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Nat Cardiovasc Res. 2022 Jun;1(6):562-567. doi: 10.1038/s44161-022-00080-2. Epub 2022 Jun 10.
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Effect of Beta-blockers on Extracranial Arteriovenous Malformations.β受体阻滞剂对颅外动静脉畸形的影响。
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Successful management of an arteriovenous malformation with trametinib in a patient with capillary-malformation arteriovenous malformation syndrome and cardiac compromise.成功应用曲美替尼治疗毛细血管畸形-动静脉畸形综合征伴心脏合并症患者的动静脉畸形
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Clinical and angioarchitectural characteristics of spinal vascular malformations of the cervical spine.颈椎脊髓血管畸形的临床及血管构筑学特征
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Spinal and Paraspinal Arteriovenous Lesions.脊髓及椎旁动静脉病变
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Metameric spinal AVM: Long-term symptomatic relief achieved by embolization of the extradural component.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。
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Stereotactic radiosurgery and fractionated radiotherapy for spinal arteriovenous malformations - A systematic review of the literature.立体定向放射外科和分次放射治疗脊髓动静脉畸形——文献系统综述
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Genotype-Guided Medical Treatment of an Arteriovenous Malformation in a Child.基于基因型的儿童动静脉畸形的医学治疗。
JAMA Dermatol. 2019 Feb 1;155(2):256-257. doi: 10.1001/jamadermatol.2018.4653.
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