PMID: 6536268Jan 1, 1984Paper

Arteriovenous malformations of the spinal cord

Advances and Technical Standards in Neurosurgery
M G YaşargilP J Teddy

Abstract

The operative experience in Zürich of forty-one cases of spinal AVM with major intramedullary components showed that it was possible, with the aid of precise microsurgical techniques, to remove completely 60% of these lesions with improvement, or, at least, without deterioration in neurological condition. A further 12% could be apparently effectively palliated by subtotal removal. Radical surgery may be justified in patients with irreversible neurological deficits to treat pain and to prevent fatal SAH. The best results have generally been obtained in patients with less severe neurological deficits and with lesions in the cervical region rather than the thoracolumbar region. The natural history of intramedullary spinal AVMs--that of deterioration after recurrent haemorrhage--is analogous to that of intracranial aneurysms--and the need for earlier diagnosis and for early preventive surgery is the same for both. It would, perhaps, be preferable to treat all cases of spinal AVM by transvascular occlusion to obviate the risk of open surgery and of spinal deformity, but some AVMs will remain impossible to treat by this means and the long term results of embolization still require full analysis before it can be accepted as definitive...Continue Reading

Citations

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