Combined Spinal Arteriovenous Malformation and Spinal Dysraphism.

Abstract

Spinal vascular malformations as a group are rare, and coexistence of a spinal arteriovenous malformation (AVM) in or around the spinal dysraphism is extremely rare. We report 2 cases of combined spinal dysraphism and vascular malformations of the spinal cord. The first case was an AVM located in a filum terminale lipoma fed by the artery of the filum terminale. This case was managed by multiple endovascular embolizations followed by surgery. The second case was an AVM located in a lumbar lipomyelocele managed by endovascular embolization. These cases illustrate the imaging findings of a rare entity and present the diagnostic and therapeutic challenges. Endovascular embolization combined with surgical resection is the most commonly used treatment for spinal dysraphism with spinal cord AVM. Careful analysis of spinal angiography is necessary owing to the distorted vascular and surgical anatomy of the region affected by spinal dysraphism.