1. Cervical intraosseous arteriovenous malformation: report of a rare entity and its management dilemmas.
- Author
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Khan K, Thakar S, Rao TMN, Kanneganti V, and Aryan S
- Subjects
- Humans, Male, Adult, Vertebral Artery diagnostic imaging, Vertebral Artery surgery, Vertebral Artery abnormalities, Spinal Cord Compression surgery, Spinal Cord Compression etiology, Spinal Cord Compression diagnostic imaging, Treatment Outcome, Magnetic Resonance Imaging, Laminectomy methods, Decompression, Surgical methods, Cervical Vertebrae surgery, Cervical Vertebrae diagnostic imaging, Arteriovenous Malformations diagnostic imaging, Arteriovenous Malformations surgery, Arteriovenous Malformations therapy, Embolization, Therapeutic methods
- Abstract
Intraosseous occurrence of a spinal AVM is anecdotal, with only four such cases reported previously. This is the first report of a spinal intraosseous AVM in the cervical vertebrae. A 44-year-old male patient presented with a 2-month history of progressive quadriparesis and bladder dysfunction. Magnetic resonance imaging showed multiple flow voids within the C4 and C5 vertebral bodies, and an extradural component causing cord compression. CT showed extensive bony destruction at both levels. The diagnosis of an intraosseous AVM was confirmed with spinal angiography. The AVM was noted to be fed by branches from the ascending cervical arteries and the vertebral artery. The nidus was draining into the vertebral venous plexus and thence into the jugular vein through the marginal sinus. The patient underwent partial embolization of the AVM. Surgical resection was attempted but found to be unfeasible due to torrential bleeding. A 360-degree stabilization along with decompressive laminectomies was performed, resulting in clinical improvement and disease stabilization at one year follow-up. The case and its management dilemmas are discussed in light of a brief literature review., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)
- Published
- 2024
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