link
Bookmarks
Complex Spinal Cord Arteriovenous Malformation (Type 3)
Jeffrey S. Ross, MD
To access 4,300 diagnoses written by the world's leading experts in radiology, please log in or subscribe.Log inSubscribe
0
5
3
0

KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Synonyms

                • Juvenile arteriovenous malformation (AVM); intramedullary extramedullary AVM
              • Definitions

                • 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

                                              1. Peckham ME et al: Imaging of vascular disorders of the spine. Radiol Clin North Am. 57(2):307-18, 2019
                                              2. Takai K: Spinal arteriovenous shunts: angioarchitecture and historical changes in classification. Neurol Med Chir (Tokyo). 57(7):356-65, 2017
                                              3. Rubin MN et al: Vascular diseases of the spinal cord. Neurol Clin. 31(1):153-81, 2013
                                              4. 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
                                              5. 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
                                              6. Johnson WD et al: Variety of spinal vascular pathology seen in adult Cobb syndrome. J Neurosurg Spine. 10(5):430-5, 2009
                                              7. Backes WH et al: Advances in spinal cord MR angiography. AJNR Am J Neuroradiol. 29(4):619-31, 2008
                                              8. 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
                                              9. 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
                                              10. 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
                                              11. 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
                                              12. Spetzler RF et al: Modified classification of spinal cord vascular lesions. J Neurosurg. 96(2 Suppl): 145-56, 2002
                                              13. 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
                                              14. 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
                                              15. Ferch RD et al: Spinal arteriovenous malformations: a review with case illustrations. J Clin Neurosci. 8(4): 299-304, 2001
                                              16. Mascalchi M et al: Spinal vascular malformations: MR angiography after treatment. Radiology. 219(2): 346-53, 2001
                                              17. 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
                                              18. Hasegawa M et al: The efficacy of CT arteriography for spinal arteriovenous fistula surgery: technical note. Neuroradiology. 41(12): 915-9, 1999
                                              19. Mandzia JL et al: Spinal cord arteriovenous malformations in two patients with hereditary hemorrhagic telangiectasia. Childs Nerv Syst. 15(2-3): 80-3, 1999
                                              20. Bao YH et al: Classification and therapeutic modalities of spinal vascular malformations in 80 patients. Neurosurgery. 40(1):75-81, 1997
                                              Related Anatomy
                                              Loading...
                                              Related Differential Diagnoses
                                              Loading...
                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Synonyms

                                                            • Juvenile arteriovenous malformation (AVM); intramedullary extramedullary AVM
                                                          • Definitions

                                                            • 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

                                                                                          1. Peckham ME et al: Imaging of vascular disorders of the spine. Radiol Clin North Am. 57(2):307-18, 2019
                                                                                          2. Takai K: Spinal arteriovenous shunts: angioarchitecture and historical changes in classification. Neurol Med Chir (Tokyo). 57(7):356-65, 2017
                                                                                          3. Rubin MN et al: Vascular diseases of the spinal cord. Neurol Clin. 31(1):153-81, 2013
                                                                                          4. 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
                                                                                          5. 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
                                                                                          6. Johnson WD et al: Variety of spinal vascular pathology seen in adult Cobb syndrome. J Neurosurg Spine. 10(5):430-5, 2009
                                                                                          7. Backes WH et al: Advances in spinal cord MR angiography. AJNR Am J Neuroradiol. 29(4):619-31, 2008
                                                                                          8. 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
                                                                                          9. 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
                                                                                          10. 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
                                                                                          11. 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
                                                                                          12. Spetzler RF et al: Modified classification of spinal cord vascular lesions. J Neurosurg. 96(2 Suppl): 145-56, 2002
                                                                                          13. 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
                                                                                          14. 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
                                                                                          15. Ferch RD et al: Spinal arteriovenous malformations: a review with case illustrations. J Clin Neurosci. 8(4): 299-304, 2001
                                                                                          16. Mascalchi M et al: Spinal vascular malformations: MR angiography after treatment. Radiology. 219(2): 346-53, 2001
                                                                                          17. 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
                                                                                          18. Hasegawa M et al: The efficacy of CT arteriography for spinal arteriovenous fistula surgery: technical note. Neuroradiology. 41(12): 915-9, 1999
                                                                                          19. Mandzia JL et al: Spinal cord arteriovenous malformations in two patients with hereditary hemorrhagic telangiectasia. Childs Nerv Syst. 15(2-3): 80-3, 1999
                                                                                          20. Bao YH et al: Classification and therapeutic modalities of spinal vascular malformations in 80 patients. Neurosurgery. 40(1):75-81, 1997