Dhopesh V P, Weinstein J D
Dis Nerv Syst. 1977 Oct;38(10):848-51.
Two cases of spinal arteriovenous malformation (AVM) in young patients are presented. Symptoms were compatible with the spinal form of multiple sclerosis in both cases. The lesions were not diagnosed on initial evaluation. Subsequently they were found by myelography and arteriography, the one eight months and the other nine years after the first symptoms. The contrasting clinical courses of the two patients suggest that: (a) the diagnosis of multiple sclerosis where symptoms and signs are restricted to the spinal cord should be made only after a thorough investigation which includes myelography, to rule out the presence of a surgically correctible lesion such as an AVM; (b) myelography should be carried out in both the supine and prone positions as an AVM may be completely missed by routine prone myelography views; (c) early surgery of the resectable AVM may prevent a progressive deterioration of neurological function, making early diagnosis particularly important.
本文介绍了两例年轻患者的脊髓动静脉畸形（AVM）。两例患者的症状均与脊髓型多发性硬化症相符。在初次评估时均未诊断出病变。随后通过脊髓造影和动脉造影发现了病变，一例是在首次出现症状八个月后，另一例是在首次出现症状九年后。两位患者截然不同的临床病程表明：（a）对于症状和体征仅限于脊髓的多发性硬化症，只有在进行包括脊髓造影在内的全面检查以排除可手术纠正的病变（如AVM）后，才能做出诊断；（b）脊髓造影应在仰卧位和俯卧位进行，因为常规俯卧位脊髓造影可能会完全漏诊AVM；（c）可切除AVM的早期手术可能会防止神经功能的进行性恶化，这使得早期诊断尤为重要。
