Spinal Vascular Malformations

Chapter

Abstract

The conditions usually grouped under the rubric of «vascular malformations of the spinal cord» represent distinct entities that, in fact, have little in common with each other. The three main players – spinal dural fistula (SDF), spinal arteriovenous malformation (SAVM), and spinal pial fistula (SPF) – all differ in demographics, modes of presentation, pathophysiologic and pathoanatomical features (as best determined by spinal angiography), and treatment strategies. For historical and technical reasons, these diseases have been listed together in various classifications schemes, including the enduring Spetzler classification (J Neurosurg 96:145–156, 2002), which is a simple and practical guide that continues to be useful. To this group of diseases are added a number of even rarer conditions such as the epidural fistula, which do not figure in this theme. An overarching classification of both cranial and spinal vascular shunts was also proposed by Rodesch, Lasjaunias and colleagues in 2008 (Rodesch, Neurosurgery 51:374–379; discussion 379–380, 2002), based on embryologic considerations and supported by demographic and clinical similarities between homologous cerebral and spinal shunt subtypes. Despite its physiologic plausibility, the system does not appear to have gained wide acceptance. The prevalent tendency in the literature is to discuss each disease by its unique name, which underscores recognition within the neurovascular community that it is crucial to establish a specific diagnosis for each individual case.

Notes

Acknowledgements

The author gratefully acknowledges the following teachers and contributors: Doctors Tibor Becske, Anthony Frempong-Boadu, Paul Huang, Peter Kim Nelson, Donato Pacione, Eytan Raz, Daniel Sahlein. NYULMC and Bellevue HHC neurointerventional staff.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Bernard and Irene Schwartz Interventional Neuroradiology Section, Departments of Radiology and NeurologyNYU School of Medicine, NYU Langone Medical CenterNew YorkUSA

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