Spinal Arteriovenous Malformation (AVM)
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About Spinal Arteriovenous Malformation (AVM)
General Information
- Spinal arteriovenous malformations (AVMs) are abnormal collections of blood vessels in the spinal canal that have a direct connection between the arterial system and the venous system without intervening capillaries.
- AVMs account for about 4 percent of primary intraspinal masses, so the actual number of cases is very low. Eighty percent occur between ages 20 and 60.
- Spinal dural AVMs are the most common type in adults.
- Intradural AVMs are located outside the substance of the spinal cord.
- Intramedullary AVMs are located within the substance of the spinal cord.
Symptoms
- Eighty-five percent of spinal AVMs involve progressive neurological symptoms over months to years, especially back pain associated with progressive sensory loss and lower extremity weakness.
- Ten percent to 20 percent involve a sudden onset of weakness, numbness, difficulty urinating, urinary incontinence, fecal incontinence, or paralysis (usually in patients younger than 30) as a result of hemorrhage.
Diagnosis
- The advent of magnetic resonance imaging (MRI) has increased the likelihood of identifying spinal AVM lesions.
- Spinal angiography is used to map the vascular structure.
Treatment
- The treatment plan is formulated after careful consideration of the patient's clinical history, the symptoms, the physical examination and available diagnostic studies.
- Some lesions can be treated via minimally invasive endovascular embolization of the AVM to obliterate it.
- Lesions that have hemorrhage usually require surgical removal, especially those within the spinal cord or compressing the spinal cord.
The Neuro-ICU cares for patients with all types of neurosurgical and neurological injuries, including stroke, brain hemorrhage, trauma and tumors. We work in close cooperation with your surgeon or medical doctor with whom you have had initial contact. Together with the surgeon or medical doctor, the Neuro-ICU attending physician and team members direct your family member's care while in the ICU. The Neuro-ICU team consists of the bedside nurses, nurse practitioners, physicians in specialty training (Fellows) and attending physicians. UCLA Neuro ICU Family Guide