The spinal epidural vascular malformations
Keywords:
spinal epidural space, vascular malformationsAbstract
STUDY DESIGN. Spinal epidural vascular malformations are extremely rare. Among them singled out arteriovenous fistulas, venous malformations and epidural varices. Now, little known about their diagnosis, management and results.
For the PURPOSE to study clinical course, therapeutic modalities, surgical technique and results the current study was undertaken.
MATERIAL AND METHODS: Forty-one cases of vascular malformations affecting the spinal epidural spaces were retrospectively reviewed. The methods of treatment, hystological similarities and differences between malformations at each type are reviewed.
RESULTS. Two patients had arteriovenous fistulas, tree had venous malformations and 36 patients had epidural varices with represent the major group of epidural malformations. The arteriovenous fistulas are a direct contact radicular artery with epidural veins. The pathology led to blood congestion in veins, their distention, and indirect cord compression or raised spinal venous pressure. The venous malformations are tingles of small veins in epidural spaces that caused spinal cord compression. The epidural varices are distension epidural veins unknown etiology. Venous outflow obstruction or congestion has been implicated in the etiology of some lumbar radicular syndromes. All cases of epidural varices manifesting themselves as masses within the lumbar spinal canal or adjacent foramina have been seen. Long time lumbar epidural varices have been infrequently described in the literature and rarely accepted as a primary pathophysiological entity. Now it considered as a primary pathology. The treatment of arteriovenous fistulas, and venous malformations included their devascularisation and resection. The treatment of epidural varices included their coagulation and neural decompression.
CONCLUSIONS. Knowledge of the existence of these pathological entities, its possible etiologies, and its imaging characteristics may assist in its recognition and improved management of patients with it.
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