Venous congestive myelopathy: three autopsy cases showing a variety of clinicopathologic features

Neuropathology : Official Journal of the Japanese Society of Neuropathology
Koushun MatsuoHitoshi Takahashi

Abstract

We describe three patients with progressive myelopathy, in whom autopsy revealed spinal cord pathology compatible with that of venous congestive myelopathy (VCM) associated with dural arteriovenous fistula (AVF), formerly known as angiodysgenetic necrotizing myelopathy (Foix-Alajournine syndrome). In these three patients, common symptoms were gait disturbance and sensory disturbance of the extremities, and these symptoms slowly worsened. The clinical diagnoses varied and included spinal cord intramedullary tumor, cervical spondylosis and multiple sclerosis. At autopsy, all the patients showed enlarged, tortuous venous vessels on the dorsal surfaces of the spinal cord at the affected levels. In the affected spinal cord parenchyma, necrotic lesions manifested by various degrees of neuronal loss and gliosis, with increased numbers of hyalinized vessels, were evident. The presence or absence of associated spinal dural AVF could not be identified histopathologically. Even with the help of modern neurological examination methods, early and accurate clinical diagnosis of VCM is sometimes difficult. When encountering patients with progressive myelopathy, VCM, although recognized as rare, should be considered as an important differentia...Continue Reading

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Citations

Jul 28, 2009·Neurologia Medico-chirurgica·Satoshi TsutsumiMasanori Ito
Jan 6, 2009·Neurosurgical Focus·Amir R DehdashtiM Christopher Wallace
May 16, 2009·The Spine Journal : Official Journal of the North American Spine Society·E Andrew StevensJohn A Wilson
Jun 21, 2013·Brain and Behavior·Eric P RogerMarygrace C Hagan
Mar 27, 2015·Neurosurgery·Toru SasamoriKiyohiro Houkin
May 20, 2016·Neurosurgical Review·Toru SasamoriKiyohiro Houkin
May 22, 2016·World Neurosurgery·Johannes GoldbergDavid Bervini

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