Spinal Cord Avm

Superglued Heart

An arteriovenous malformation (AVM) is an abnormal collection of blood vessels. Normally, arteries carry oxygenated blood away from the heart to the body. Generally, the arteries get smaller as they get further away from the heart. They feed into the tiniest blood vessels, the capillaries, where oxygen is released into the tissues. The capillaries also pick up carbon dioxide and waste products. From here, the capillaries are connected to the veins, and take the deoxygenated blood back to the lungs and heart. In an AVM, there is an abnormal growth of excess arteries and veins, causing the formation of a tangled mass of blood vessels. The vessels typically have abnormal connections, which allow oxygenated blood to flow directly into the veins, causing some of the blood to bypass the capillaries. As a result, the tissues fed by the affected artery may not get enough oxygen. The blood vessel defects that lead to AVMs are believed to form during embryonic or fetal development. Only about 12 percent of those with AVMs develop symptoms or problems related to the abnormal blood vessels. For example, an AVM in the brain or spinal cord (the most common sites) can cause headaches, back pain, seizures or significant hemorrhage. Recently, doctors at the University of Rochester Medical Center in Rochester, NY treated a patient with a very large cardiac AVM. Interventional Cardiologist, Christopher Cove, M.D., says the AVM was taking up almost all the space inside the left ventricle (the main pumping chamber of the heart). That left little room for blood in the chamber, reducing blood flow to the body and depriving organs and tissues of oxygen. In addition, the mass of blood vessels have their own need for blood, causing them to continue to grow and steal blood away from the heart muscle. While the AVM patient waited for a donor heart, her condition continued to deteriorate. One day, while watching neurosurgeons fix an AVM in the brain with a medical superglue, called Onyx®, Cove thought a similar procedure may be useful for his heart patient. He consulted with Cerebral Vascular Neurosurgeon, Babak Jahromi, M.D., Ph.D., who was very cautious because the vascular anatomy of the brain is very different from that of the heart. In addition, the heart moves as it beats, while brain tissue remains still.

Radiology Picture of the Day » Archives » Spinal cord AVM

A 44yo woman presented with sudden onset flaccid paraparesis and a sensory level at T12. MRI demonstrated acute haemorrhage in the distal cord and conus medullaris. MR angiography confirmed the presence of an arteriovenous malformation. Under general anaesthesia, spinal angiography was performed, demonstrating a glomus-type medullary AVM of the spinal cord. A microcatheter was advanced along the anterior spinal artery and the nidus and draining vein occluded with ethyl vinyl alcohol copolymer. The patient made an excellent recovery and regained normal power and sensation in her lower limbs. The montage demonstrates initial angiography performed in the right L2 lumbar artery (left) showing supply via the anterior spinal artery (ASA) to a compact AVM nidus with two intranidal aneurysms (almost certainly the cause of haemorrhage), draining to the coronal perimedullary venous plexus. The second image (middle) shows superselective angiography through the microcatheter, which has its tip at the junction between the ASA and the nidus. The third image (right) shows post embolisation angiography in the right L2 lumbar artery. The embolic cast is clearly visible, and the ASA proximal to the nidus remains patent, although it is not seen on this late-phase angiogram.

Spine Radiosurgery

Given the various subtypes of spinal cord AVMs, those with a relatively compact ... Spinal cord AVMs are typically classified into four distinct pathologic ...

Diagnostic Neuroradiology

Incidence of spinal cord AVM makes up 4–5% of all pathologic mass lesions ... Spinal cord AVM is predominantly localised in the thoracic and cervical spine; ...

Arteriovenous malformations in functional areas of the brain

AVMs in the Spinal Cord The term "AVM nidus" was coined by Dopp- man23 to ... In the senior author's experience, a spinal cord AVM (particularly those of ...

Surgery of the pediatric spine

Although the natural history of spinal cord AVMs is not well defined, it seems reasonable to presume that the incidence of hemorrhage does not differ ...

Diseases of the spine and spinal cord

More recently, spinal vascular malformations have been classified into 4 types: type I—dural arteriovenous fistula (AVF); type II—spinal cord AVM; ...