Zhang Ye, Zheng Liaoyuan, Huang Yongwei, Li Zongping, Feng Jing
Department of Neurosurgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, China.
Department of Breast Surgery, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, China.
Front Surg. 2025 Jan 6;11:1487979. doi: 10.3389/fsurg.2024.1487979. eCollection 2024.
Spinal cord vascular malformations (SCVMs) in children are relatively rare and present unique challenges due to their distinct physiological characteristics. These malformations often manifest with nonspecific clinical symptoms, increasing the likelihood of misdiagnosis. The treatment of pediatric SCVMs requires a tailored approach, with the choice between microsurgical intervention and endovascular embolization depending on the specific type of malformation and individual patient factors.
We report a case of a 6-year-old male who presented with a sudden onset of headache. Initial cranial imaging did not reveal any significant intracranial vascular malformations. However, thoracic spine magnetic resonance imaging (MRI) identified an abnormal signal, and digital subtraction angiography (DSA) confirmed the diagnosis of SCVMs. The patient underwent microsurgical treatment and was discharged in good health. Follow-up DSA confirmed the complete resolution of the vascular malformations.
This case, along with a review of the literature, underscores the importance of thorough spinal evaluations in pediatric patients with spontaneous intracranial hemorrhage, especially when intracranial vascular malformations are not identified. A high index of suspicion for SCVMs is crucial. Early and accurate diagnosis, followed by appropriate treatment through microsurgical resection or endovascular embolization, can significantly improve therapeutic outcomes in children with SCVMs.
儿童脊髓血管畸形（SCVMs）相对罕见，因其独特的生理特征而带来独特挑战。这些畸形常表现为非特异性临床症状，增加了误诊的可能性。小儿SCVMs的治疗需要量身定制的方法，根据畸形的具体类型和个体患者因素在显微手术干预和血管内栓塞之间做出选择。
我们报告一例6岁男性患儿，突发头痛。最初的头颅影像学检查未发现任何明显的颅内血管畸形。然而，胸椎磁共振成像（MRI）发现异常信号，数字减影血管造影（DSA）确诊为SCVMs。该患者接受了显微手术治疗，出院时身体健康。随访DSA证实血管畸形已完全消失。
本病例及文献复习强调了对自发性颅内出血小儿患者进行全面脊髓评估的重要性，尤其是在未发现颅内血管畸形时。对SCVMs保持高度怀疑至关重要。早期准确诊断，随后通过显微手术切除或血管内栓塞进行适当治疗，可显著改善小儿SCVMs的治疗效果。
