Repozitorij Medicinskog fakulteta Sveučilišta u Zagrebu

Coexistence of intradural spinal arteriovenous malformation and associated developmental anomalies – report of two cases

Telarović, Srđana and Šarac, Helena and Žagar, Marija and Markeljević, Jasenka and Vranješ, Davorka and Radoš, Marko (2011) Coexistence of intradural spinal arteriovenous malformation and associated developmental anomalies – report of two cases. Collegium Antropologicum, 35 (Suppl.). pp. 319-25. ISSN 0353-3735

[img]
Preview
PDF
Download (185Kb) | Preview

    Croatian abstract

    INTRADURALNA SPINALNA ATRIOVENSKA MAFORMACIJA UDRUŽENA S RAZVOJNIM ANOMALIJAMA: PRIKAZ DVA SLUČAJA ----- Spinalne arteriovenske malformacije su klasificirane u intraduralne (Tip I), intramedularni glomus (Tip II), juvenilne (Tip III) i perimedularne direktne arteriovenske fistule (Tip IV). Arteriovenske malformacije su obično udružene sa subakutnom mijelopatijom u sindromu Foix-Alajouanine. U ovoj studiji, opisuju se dijagnostičke i terapijske procedure u dva bolesnika sa spinalnom arteriovenskom malformacijom i Foix-Alajouanin sindromom. Oba bolesnika u početku su imali simptome akutne boli u leđima i parestezije, a potom se stanje klinički pogoršalo do potpune paraplegije i inkontinencije. Jedan bolesnik bio je klinički stabilan 17 godina nakon višekratnih postupaka endovaskularne embolizacije, ali je nakon zadnjeg rutinskog postupka kontrolne spinalne angiografije doživio kliničko pogoršanje do potpune paraplegije, vjerojatno uslijed vazospazma. Kod drugog bolesnika klinički status se progresivno pogoršavao do parapareze budući da se terapijska endovaskularna embolizacija nije mogla provesti zbog izrazito diskretne prezentacija »hranidbenih« arterija. Opsežna radiološka obrada u oba bolesnika otkrila je niz konkomitantnih razvojnih anomalija. Iz ovih podataka možemo zaključiti da spinalne arteriovenske malformacije mogu ponekad biti udružene s drugim krvožilnim i drugim razvojnim malformacijama, ne samo u centralnom živčanom sustavu nego u bilo kojem dijelu tijela. Iz toga slijedi da kod bolesnika kod kojih se objektivizira spinalna arteriovenska malformacija, treba biti učinjena šira dijagnostička obrada. Iz ovoga se također može pretpostaviti da bi ove anomalije mogle imati zajedničku etiopatogenezu koja sugerira kongenitalno porijeklo i uzroke ovih razvojnih anomalija. Rana dijagnostika i terapijski postupci mogu spriječiti ili odgoditi ireverzibilnu ishemijsku mijelopatiju ili hemoragiju. Za konačnu dijagnozu spinalnih arteriovenskih malformacija i evaluaciju okluzija nakon terapijskog postupka neophodna je spinalna angiografija.

    English abstract

    Spinal arteriovenous malformations (AVM) have been devided into dural (Type I), intramedullary glomus (Type II), juvenile (Type III), and perimedullary direct arteriovenous fistulae (Type IV). AVMs are usually associated with subacute myelopathy in what has been known as Foix-Alajouanine syndrome.We presented two patients with two intradural spinal arteriovenous malformations associated in what we call Foix-Alajouanine syndrome. The both patient developed acute back pain and paresthesias, followed by paraplegia and incontinence. The clinical status of one patient has been improved after particle embolization for a 17 years when he deteriorated up to paraplegia after spinal angiography for follow up. Clinical status in another patient deteriorated, because particle emoblisation cannot be performed due to very descrete presentation of the feeding artery. Extensive neuroradiological examination in both patients revealed coexistence of numerous associated developmental anomalies in both patients.We conclude that arteriovenous malformations occasionally are associated with other vascular and nonvascular developmental anomalies elsewhere in the body. These findings rise attention about keep in mind the suspicion of mutual etiopathogenesis and congenital origin of these anomalies. Early timing of the diagnostic and therapeutic interventiosn are stressed to prevent or delay irreversible ishaemic myellopathy or haemorrhage. For the definitive diagnosis of spinal arteriovenous malformations and evaluation of its occlusion grade after the therapy spinal angiography is needed.

    Item Type: Article
    Divisions: Katedra za internu medicinu
    Katedra za radiologiju i opću kliničku onkologiju
    Hrvatski institut za istraživanje mozga
    Depositing User: Marijan Šember
    Status: Published
    Creators:
    CreatorsEmail
    Telarović, Srđana
    Šarac, Helena
    Žagar, Marija
    Markeljević, Jasenka
    Vranješ, Davorka
    Radoš, Marko
    Date: January 2011
    Date Deposited: 22 Mar 2011
    Last Modified: 23 Sep 2011 18:11
    Subjects: /
    Related URLs:
      URI: http://medlib.mef.hr/id/eprint/973

      Actions (login required)

      View Item

      Document Downloads

      More statistics for this item...