Paraplegia following surgery in Foix and Alajouanine syndrome. (Arteriovenous malformation of the spinal cord).

Two patients with spinal cord arteriovenous malformation became paraplegic after removal of the abnormal vessels from the dorsal surface of the thoracolumbar spinal cord. Surgical exposure of a spinal cord arteriovenous malformation without an attempt at removal accelerated the pace of progressive paraparesis in two other patients. The poor outcome of our cases is, however, not representative of modern surgical techniques, since selective spinal angiography and the operating microscope were not used. We propose that the intramedullary vascular changes in this condition are an integral component of the arteriovenous malformation. Additionally, the phenomenon of nocturnal seminal ejaculation in spite of progressing impotence may be a clinical feature unique to spinal cord arteriovenous malformations.