Lv Xianli
Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, China.
Neuroradiol J. 2025 Jan 9:19714009251313506. doi: 10.1177/19714009251313506.
The spinal arteriovenous malformations (sAVMs) have been challenging entities to diagnose and treat. The small structure, important function, and complex vascular anatomy of the spinal cord increase the difficulty of treating sAVMs.
The combining holistic and local perspectives in the diagnosis and treatment of sAVMs were provided to teach spinal vascular anatomy and AVMs.
A holistic view is to fully understand the anatomical and physiological effects of intracranial vascular lesions on the spinal cord circulatory system, as well as the anatomical and physiological effects of local sAVM on the entire spinal cord circulatory system, such as the relationship between lesions and surrounding blood vessels. The local view is to fully understand the macroscopic and microscopic vascular architectural characteristics of the lesion. The local view is closely related to the treatment of lesions and the holistic view is closely related to the effectiveness and side effects of treatment, which should be given attention in current clinical practice. The early diagnosis and treatment of sAVMs may improve outcomes.
A holistic and local perspective is essential to developing an understanding of the angioarchitecture, pathophysiology, natural history, treatment options, and classification of the different types of sAVMs.
脊髓动静脉畸形(sAVM)的诊断和治疗一直具有挑战性。脊髓结构微小、功能重要且血管解剖复杂,增加了sAVM治疗的难度。
提供在sAVM诊断和治疗中结合整体与局部观点的方法,以讲授脊髓血管解剖和动静脉畸形。
整体观点是充分了解颅内血管病变对脊髓循环系统的解剖和生理影响,以及局部sAVM对整个脊髓循环系统的解剖和生理影响,如病变与周围血管的关系。局部观点是充分了解病变的宏观和微观血管结构特征。局部观点与病变治疗密切相关,整体观点与治疗效果和副作用密切相关,这在当前临床实践中应予以关注。sAVM的早期诊断和治疗可能改善预后。
整体和局部观点对于理解不同类型sAVM的血管构筑、病理生理、自然史、治疗选择和分类至关重要。