Microsurgical removal of intramedullary arteriovenous malformations

Eugene Slynko, Alexander Zolotoverkh, Iyad Al-Kashkish, Artur Ermoliev

Abstract


Introduction. Intramedullary arteriovenous malformations (IAVM) demand close attention, because they are severe vascular pathology of the spinal cord, which quickly leads to profound neurological deficits. To clarify the results of malformations’ direct surgical excision, the data of patients’ examination and treatment in period 1998–2012 years were analyzed.

Materials and methods. Treatment results of 52 patients with IAVM that have been removed or disabled by open microsurgical procedures were analyzed.

Results. Immediately after surgery in 43 of 52 patients transient worsening of neurological symptoms was observed. At 3 months after surgery neurological symptoms were not worse than before operation. Further significant or partial regression of preoperative neurologic symptoms were observed in 48 patients in 3–24 months after surgery. In 4 patients initial neurological symptoms did not change.

Conclusions. Today IAMV microsurgical removal is quite dangerous, but there are no more effective methods for their neurosurgical treatment.


Keywords


intramedullary arteriovenous malformation; treatment results

References


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GOST Style Citations


1. Modified classification of spinal cord vascular lesions / R.F. Spetzler, P.W. Detwiler, H.A. Riina, R.W. Porter // J. Neurosurg. —2002. — V.96, N2. — P.145–156.

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3. MacFarlane M.R. Excision of high and mid cervical spinal cord arteriovenous malformations by anterior operation / M.R. MacFarlane, P.J. Burn, J. Evison // J. Clin. Neurosci. — 2005. — V.12, N1. — P.71–79.

4. Corkill R.A. Embolization of spinal intramedullary arteriovenous malformations using the liquid embolic agent, Onyx: a single-center experience in a series of 17 patients / R.A. Corkill, A.P. Mitsos, A.J. Molyneux // J. Neurosurg. Spine. — 2007. — V.7, N5. — P.478–485.

5. Posterior approach for cervical intramedullary arteriovenous malformation with diffuse-type nidus. Report of three cases / K. Ohata, T. Takami, A. El-Naggar [et al.] // J. Neurosurg. — 1999. — V.91, N1. — P.105–111.

6. Hall W.A. Recanalization of spinal arteriovenous malformations following embolization / W.A. Hall, E.H. Oldfield, J.L. Doppman // J. Neurosurg. — 1989. — V.70, N5. — P.714–720.

7. Treatment of intramedullary arteriovenous malformations of the spinal cord / S. Ushikoshi, K. Hida, Y. Kikuchi [et al.] // Interv. Neuroradiol. — 2000. — V.30, N6. — P.203–207.

8. Tai P.A. Surgical treatment of spinal arteriovenous malformations: vascular anatomy and surgical outcome / P.A. Tai, Y.K. Tu, H.M. Liu // J. Formos Med. Assoc. — 2001. — V.100, N6. — P.389–396.





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