Direct arterial/venous communications without capillary bed involving cord
General spine vascular malformation classification
Type 1: Dural arteriovenous fistula (dAVF)
Most common type (up to 80%)
Type 2: Intramedullary glomus-type AVM (similar to brain AVM)
Type 3: Juvenile-type AVM (large, complex, intramedullary extramedullary AVM)
Rarest of spinal AVMs (7%)
Type 4: Intradural extra-/perimedullary AVF
IMAGING
General Features
CT Findings
MR Findings
Angiographic Findings
Nonvascular Interventions
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Peckham ME et al: Imaging of vascular disorders of the spine. Radiol Clin North Am. 57(2):307-18, 2019
Takai K: Spinal arteriovenous shunts: angioarchitecture and historical changes in classification. Neurol Med Chir (Tokyo). 57(7):356-65, 2017
Rubin MN et al: Vascular diseases of the spinal cord. Neurol Clin. 31(1):153-81, 2013
Schirmer CM et al: Obliteration of a metameric spinal arteriovenous malformation (Cobb syndrome) using combined endovascular embolization and surgical excision. J Neurosurg Pediatr. 10(1):44-9, 2012
Spiotta AM et al: Combined endovascular and surgical resection of a giant lumbosacral arteriovenous malformation in a patient with Cobb syndrome. J Neurointerv Surg. 3(3):293-6, 2011
Johnson WD et al: Variety of spinal vascular pathology seen in adult Cobb syndrome. J Neurosurg Spine. 10(5):430-5, 2009
Backes WH et al: Advances in spinal cord MR angiography. AJNR Am J Neuroradiol. 29(4):619-31, 2008
Mull M et al: Value and limitations of contrast-enhanced MR angiography in spinal arteriovenous malformations and dural arteriovenous fistulas. AJNR Am J Neuroradiol. 28(7):1249-58, 2007
Menku A et al: Successful surgical excision of juvenile-type spinal arteriovenous malformation in two stages following partial embolization. Minim Invasive Neurosurg. 48(1):57-62, 2005
Rodesch G et al: Classification of spinal cord arteriovenous shunts: proposal for a reappraisal--the Bicetre experience with 155 consecutive patients treated between 1981 and 1999. Neurosurgery. 51(2): 374-9; discussion 379-80, 2002
Saraf-Lavi E et al: Detection of spinal dural arteriovenous fistulae with MR imaging and contrast-enhanced MR angiography: sensitivity, specificity, and prediction of vertebral level. AJNR Am J Neuroradiol. 23(5): 858-67, 2002
Spetzler RF et al: Modified classification of spinal cord vascular lesions. J Neurosurg. 96(2 Suppl): 145-56, 2002
Van Dijk JM et al: Multidisciplinary management of spinal dural arteriovenous fistulas: clinical presentation and long-term follow-up in 49 patients. Stroke. 33(6): 1578-83, 2002
Bemporad JA et al: Magnetic resonance imaging of spinal cord vascular malformations with an emphasis on the cervical spine. Neuroimaging Clin N Am. 11(1): viii, 111-29, 2001
Ferch RD et al: Spinal arteriovenous malformations: a review with case illustrations. J Clin Neurosci. 8(4): 299-304, 2001
Mascalchi M et al: Spinal vascular malformations: MR angiography after treatment. Radiology. 219(2): 346-53, 2001
Rosenow J et al: Type IV spinal arteriovenous malformation in association with familial pulmonary vascular malformations: case report. Neurosurgery. 46(5): 1240-4; discussion 1244-5, 2000
Hasegawa M et al: The efficacy of CT arteriography for spinal arteriovenous fistula surgery: technical note. Neuroradiology. 41(12): 915-9, 1999
Mandzia JL et al: Spinal cord arteriovenous malformations in two patients with hereditary hemorrhagic telangiectasia. Childs Nerv Syst. 15(2-3): 80-3, 1999
Bao YH et al: Classification and therapeutic modalities of spinal vascular malformations in 80 patients. Neurosurgery. 40(1):75-81, 1997
Direct arterial/venous communications without capillary bed involving cord
General spine vascular malformation classification
Type 1: Dural arteriovenous fistula (dAVF)
Most common type (up to 80%)
Type 2: Intramedullary glomus-type AVM (similar to brain AVM)
Type 3: Juvenile-type AVM (large, complex, intramedullary extramedullary AVM)
Rarest of spinal AVMs (7%)
Type 4: Intradural extra-/perimedullary AVF
IMAGING
General Features
CT Findings
MR Findings
Angiographic Findings
Nonvascular Interventions
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Peckham ME et al: Imaging of vascular disorders of the spine. Radiol Clin North Am. 57(2):307-18, 2019
Takai K: Spinal arteriovenous shunts: angioarchitecture and historical changes in classification. Neurol Med Chir (Tokyo). 57(7):356-65, 2017
Rubin MN et al: Vascular diseases of the spinal cord. Neurol Clin. 31(1):153-81, 2013
Schirmer CM et al: Obliteration of a metameric spinal arteriovenous malformation (Cobb syndrome) using combined endovascular embolization and surgical excision. J Neurosurg Pediatr. 10(1):44-9, 2012
Spiotta AM et al: Combined endovascular and surgical resection of a giant lumbosacral arteriovenous malformation in a patient with Cobb syndrome. J Neurointerv Surg. 3(3):293-6, 2011
Johnson WD et al: Variety of spinal vascular pathology seen in adult Cobb syndrome. J Neurosurg Spine. 10(5):430-5, 2009
Backes WH et al: Advances in spinal cord MR angiography. AJNR Am J Neuroradiol. 29(4):619-31, 2008
Mull M et al: Value and limitations of contrast-enhanced MR angiography in spinal arteriovenous malformations and dural arteriovenous fistulas. AJNR Am J Neuroradiol. 28(7):1249-58, 2007
Menku A et al: Successful surgical excision of juvenile-type spinal arteriovenous malformation in two stages following partial embolization. Minim Invasive Neurosurg. 48(1):57-62, 2005
Rodesch G et al: Classification of spinal cord arteriovenous shunts: proposal for a reappraisal--the Bicetre experience with 155 consecutive patients treated between 1981 and 1999. Neurosurgery. 51(2): 374-9; discussion 379-80, 2002
Saraf-Lavi E et al: Detection of spinal dural arteriovenous fistulae with MR imaging and contrast-enhanced MR angiography: sensitivity, specificity, and prediction of vertebral level. AJNR Am J Neuroradiol. 23(5): 858-67, 2002
Spetzler RF et al: Modified classification of spinal cord vascular lesions. J Neurosurg. 96(2 Suppl): 145-56, 2002
Van Dijk JM et al: Multidisciplinary management of spinal dural arteriovenous fistulas: clinical presentation and long-term follow-up in 49 patients. Stroke. 33(6): 1578-83, 2002
Bemporad JA et al: Magnetic resonance imaging of spinal cord vascular malformations with an emphasis on the cervical spine. Neuroimaging Clin N Am. 11(1): viii, 111-29, 2001
Ferch RD et al: Spinal arteriovenous malformations: a review with case illustrations. J Clin Neurosci. 8(4): 299-304, 2001
Mascalchi M et al: Spinal vascular malformations: MR angiography after treatment. Radiology. 219(2): 346-53, 2001
Rosenow J et al: Type IV spinal arteriovenous malformation in association with familial pulmonary vascular malformations: case report. Neurosurgery. 46(5): 1240-4; discussion 1244-5, 2000
Hasegawa M et al: The efficacy of CT arteriography for spinal arteriovenous fistula surgery: technical note. Neuroradiology. 41(12): 915-9, 1999
Mandzia JL et al: Spinal cord arteriovenous malformations in two patients with hereditary hemorrhagic telangiectasia. Childs Nerv Syst. 15(2-3): 80-3, 1999
Bao YH et al: Classification and therapeutic modalities of spinal vascular malformations in 80 patients. Neurosurgery. 40(1):75-81, 1997
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