Spinal cord arteriovenous fistulas involving the conus medullaris: Presentation, management, and embryologic considerations

Robert W. Hurst, Linda J. Bagley, Paul Marcotte, Luis Schut, Eugene S. Flamm

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

BACKGROUND: Spinal cord arteriovenous fistulas (SCAVF) are uncommon congenital lesions that usually involve the most caudal aspects of the cord. We present three cases of SCAVF that illustrate the clinical manifestations and possible management options. The characteristic involvement of the conus medullaris and an associated tethered spinal cord in one of our patient suggests that a disorder of secondary neurulation may be involved in the formation of these arteriovenous shunt lesions. METHODS: Review of records and radiologic studies in three consecutive patients with SCAVF's treated at this institution. RESULTS: All three patients had SCAVF involving the lower lumbar spinal cord segments or the conus. One of the conus lesions was associated with tethering of the spinal cord. One small lesion (Type A) was treated surgically, whereas the two larger lesions (Type B) were treated using interventional neuroradiologic techniques. CONCLUSIONS: Both surgical and endovascular method have a role in management of these unusual spinal cord vascular malformations. The association with tethered cord suggests that the propensity for SCAVM to occur in the most caudal portions of the spinal cord may result from failure of secondary neurulation to properly develop the unique and complex vascular anatomy of the region.

Original languageEnglish (US)
Pages (from-to)95-99
Number of pages5
JournalSurgical Neurology
Volume52
Issue number1
DOIs
StatePublished - Jul 1999
Externally publishedYes

Fingerprint

Arteriovenous Fistula
Spinal Cord
Neurulation
Vascular Malformations
Blood Vessels
Anatomy

Keywords

  • Fistula
  • Spinal cord
  • Spine
  • Vascular malformation

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Spinal cord arteriovenous fistulas involving the conus medullaris : Presentation, management, and embryologic considerations. / Hurst, Robert W.; Bagley, Linda J.; Marcotte, Paul; Schut, Luis; Flamm, Eugene S.

In: Surgical Neurology, Vol. 52, No. 1, 07.1999, p. 95-99.

Research output: Contribution to journalArticle

Hurst, Robert W. ; Bagley, Linda J. ; Marcotte, Paul ; Schut, Luis ; Flamm, Eugene S. / Spinal cord arteriovenous fistulas involving the conus medullaris : Presentation, management, and embryologic considerations. In: Surgical Neurology. 1999 ; Vol. 52, No. 1. pp. 95-99.
@article{17a145e78f624ed7aec6a9ff9808de3c,
title = "Spinal cord arteriovenous fistulas involving the conus medullaris: Presentation, management, and embryologic considerations",
abstract = "BACKGROUND: Spinal cord arteriovenous fistulas (SCAVF) are uncommon congenital lesions that usually involve the most caudal aspects of the cord. We present three cases of SCAVF that illustrate the clinical manifestations and possible management options. The characteristic involvement of the conus medullaris and an associated tethered spinal cord in one of our patient suggests that a disorder of secondary neurulation may be involved in the formation of these arteriovenous shunt lesions. METHODS: Review of records and radiologic studies in three consecutive patients with SCAVF's treated at this institution. RESULTS: All three patients had SCAVF involving the lower lumbar spinal cord segments or the conus. One of the conus lesions was associated with tethering of the spinal cord. One small lesion (Type A) was treated surgically, whereas the two larger lesions (Type B) were treated using interventional neuroradiologic techniques. CONCLUSIONS: Both surgical and endovascular method have a role in management of these unusual spinal cord vascular malformations. The association with tethered cord suggests that the propensity for SCAVM to occur in the most caudal portions of the spinal cord may result from failure of secondary neurulation to properly develop the unique and complex vascular anatomy of the region.",
keywords = "Fistula, Spinal cord, Spine, Vascular malformation",
author = "Hurst, {Robert W.} and Bagley, {Linda J.} and Paul Marcotte and Luis Schut and Flamm, {Eugene S.}",
year = "1999",
month = "7",
doi = "10.1016/S0090-3019(99)00038-5",
language = "English (US)",
volume = "52",
pages = "95--99",
journal = "World Neurosurgery",
issn = "1878-8750",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Spinal cord arteriovenous fistulas involving the conus medullaris

T2 - Presentation, management, and embryologic considerations

AU - Hurst, Robert W.

AU - Bagley, Linda J.

AU - Marcotte, Paul

AU - Schut, Luis

AU - Flamm, Eugene S.

PY - 1999/7

Y1 - 1999/7

N2 - BACKGROUND: Spinal cord arteriovenous fistulas (SCAVF) are uncommon congenital lesions that usually involve the most caudal aspects of the cord. We present three cases of SCAVF that illustrate the clinical manifestations and possible management options. The characteristic involvement of the conus medullaris and an associated tethered spinal cord in one of our patient suggests that a disorder of secondary neurulation may be involved in the formation of these arteriovenous shunt lesions. METHODS: Review of records and radiologic studies in three consecutive patients with SCAVF's treated at this institution. RESULTS: All three patients had SCAVF involving the lower lumbar spinal cord segments or the conus. One of the conus lesions was associated with tethering of the spinal cord. One small lesion (Type A) was treated surgically, whereas the two larger lesions (Type B) were treated using interventional neuroradiologic techniques. CONCLUSIONS: Both surgical and endovascular method have a role in management of these unusual spinal cord vascular malformations. The association with tethered cord suggests that the propensity for SCAVM to occur in the most caudal portions of the spinal cord may result from failure of secondary neurulation to properly develop the unique and complex vascular anatomy of the region.

AB - BACKGROUND: Spinal cord arteriovenous fistulas (SCAVF) are uncommon congenital lesions that usually involve the most caudal aspects of the cord. We present three cases of SCAVF that illustrate the clinical manifestations and possible management options. The characteristic involvement of the conus medullaris and an associated tethered spinal cord in one of our patient suggests that a disorder of secondary neurulation may be involved in the formation of these arteriovenous shunt lesions. METHODS: Review of records and radiologic studies in three consecutive patients with SCAVF's treated at this institution. RESULTS: All three patients had SCAVF involving the lower lumbar spinal cord segments or the conus. One of the conus lesions was associated with tethering of the spinal cord. One small lesion (Type A) was treated surgically, whereas the two larger lesions (Type B) were treated using interventional neuroradiologic techniques. CONCLUSIONS: Both surgical and endovascular method have a role in management of these unusual spinal cord vascular malformations. The association with tethered cord suggests that the propensity for SCAVM to occur in the most caudal portions of the spinal cord may result from failure of secondary neurulation to properly develop the unique and complex vascular anatomy of the region.

KW - Fistula

KW - Spinal cord

KW - Spine

KW - Vascular malformation

UR - http://www.scopus.com/inward/record.url?scp=0033168597&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033168597&partnerID=8YFLogxK

U2 - 10.1016/S0090-3019(99)00038-5

DO - 10.1016/S0090-3019(99)00038-5

M3 - Article

C2 - 10390182

AN - SCOPUS:0033168597

VL - 52

SP - 95

EP - 99

JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

IS - 1

ER -