Description

Spinal arteriovenous malformation (AVM) is a tangle of blood vessels that form on, in or near the spinal cord. This creates irregular connections between arteries and veins. Without treatment, this rare condition can cause lasting damage to the spinal cord.

The oxygen-rich blood enters the spinal cord through arteries. Arteries typically branch into smaller blood vessels called capillaries. The spinal cord receives the oxygen of the blood in the capillaries. Then, the blood passes into veins and away from the spinal cord, heart and lungs.

But in a spinal AVM , the blood passes directly from the arteries to the veins. This change in blood flow means that surrounds the cells do not receive the oxygen they need. This can cause the cells in the spinal tissue to weaken or die.

The tangled arteries and veins in a spinal AVM can also rupture and cause bleeding in the spinal cord. Sometimes, the AVM becomes larger, when the blood flow increases. The AVM may exert pressure on the spinal cord and cause weakness or other symptoms.

You might not know you have a spinal AVM unless you have symptoms. The condition can be treated with surgery to stop and even reverse some of the damage of the spinal cord.

Symptoms

The symptoms of a spinal arteriovenous malformation (AVM) can vary from person to person. The symptoms depend on where the AVM is located and how severe it is. Some people may not notice any symptoms for many years, if at all. Others may experience symptoms that are life-threatening.

The symptoms often begin when people are in their 20s, but can also occur in the earlier or later ages. Some people are diagnosed under the age of 16 years.

The symptoms can appear suddenly or slowly and may include:

  • Difficulty walking or climbing stairs.
  • Numbness, tingling, or sudden pain in the legs.
  • Weakness in one or both sides of the body.

As the condition worsens, you may have more symptoms, including:

  • Sudden back pain.
  • The lack of sensation in the legs.
  • Difficulty with urination or bowel movements.
  • The pain of a headache.
  • Stiffness in the neck.

When to see a doctor

Make an appointment with your health care professional if you experience symptoms of a spinal AVM .

Causes

The cause of spinal arteriovenous malformations (Avms) is not known. The majority of spinal Avms are present at birth, known as congenital. But others may occur later in life.

Risk factors

There are No known risk factors in the column of arteriovenous malformations (Avms). The condition occurs equally in men and women.

Complications

Without treatment, a spinal arteriovenous malformation (AVM) can cause a worsening disability over time. This is damage to the spinal cord and surrounding tissues. This can cause:

  • Difficulty to move.
  • Pain, tingling, and numbness.
  • The damage to the vertebral column.
  • Dilation of a blood vessel, known as an aneurysm.
  • Of high pressure of the blood in the veins, known as venous hypertension. This can cause the buildup of fluid called edema. It can also cause the tissues to die due to the lack of oxygen, known as infarction of the spinal cord.
  • The hemorrhage, which can accelerate the damage of the spinal cord.

Diagnosis

Spinal arteriovenous malformations (Avm) can be difficult to diagnose. The symptoms are similar to those of other spinal conditions. Other conditions include spinal dural arteriovenous fistula, spinal stenosis, multiple sclerosis or a spinal cord tumor.

Your health care professional may recommend tests to help rule out other causes of your symptoms, including:

  • Magnetic resonance imaging (MRI), which uses powerful magnets and radio waves to create detailed images of your spinal cord. Spinal magnetic resonance imaging may show a mass caused by the irregular shape connected blood vessels of an AVM .
  • Angiography,which is often needed to see the location and characteristics of the vessels involved in theAVM. In an angiogram, a thin tube, called a catheter is inserted in an artery in the groin. Has led to the spinal cord. A dye is injected into the blood vessels in the spinal cord to make them visible on x-ray images.

Angiography, it is often necessary to see the location and characteristics of the vessels involved in the AVM .

In an angiogram, a thin tube, called a catheter is inserted in an artery in the groin. Has led to the spinal cord. A dye is injected into the blood vessels in the spinal cord to make them visible on x-ray images.

Treatment

The treatment for a spinal arteriovenous malformation (AVM) may involve a combination of approaches. The treatment can ease symptoms and reduce the risk of possible complications. The choice of treatment depends on the size, location and blood flow of the spinal cord, the AVM . The results of his neurological examination and your overall health are also taken into account.

The aim of the spinal AVM treatment is to reduce the risk of AVM bleeding. The treatment may also stop or prevent disability and other symptoms worse.

Medications

To relieve the pain, medications can be used to reduce symptoms such as back pain and stiffness. But the majority of spinal arteriovenous malformations may require surgery.

Surgery

The surgery is often required to remove spinal AVM of the surrounding tissues. There are three ways to remove a spinal Avm :

  • The conventional surgery. The surgeon makes an incision in the skin to remove the AVM . The surgeon takes care of not to damage the spinal cord and its surrounding area. The surgery is usually done when the AVM is quite small and in an area of the spinal cord, which is easy to access.
  • Endovascular embolization.Endovascular embolization can decrease the risk of hemorrhage and other complications of the spinalAVMs. A catheter is inserted in an artery in the leg. The catheter is threaded into an artery in the spinal cord that feeds theAVM. Small particles of a gluelike substance is injected. This blocks the arteries and reduces the flow of blood in theAVM. This procedure does not permanently destroy theAVM. You may need to endovascular embolization before other types of surgery. This can reduce the risk of bleeding during surgery or to reduce theAVMso that the surgery is more effective.
  • The radiosurgery. This procedure uses the radiation is focused directly on the MAV to destroy the blood vessels of the malformation. Over time, the blood vessels to break and close. Radiosurgery is most often used to treat small avms that have not burst.

Endovascular embolization. Endovascular embolization can decrease the risk of hemorrhage and other complications of spinal arteriovenous malformations .

A catheter is inserted in an artery in the leg. The catheter is threaded into an artery in the spinal cord that feeds on the AVM . Small particles of a gluelike substance is injected. This blocks the arteries and reduces the blood flow into the AVM . This procedure does not permanently destroy the AVM .

You may need to endovascular embolization before other types of surgery. This can reduce the risk of bleeding during surgery or to reduce the size of the AVM for the surgery is more effective.

Your health care team will discuss with you the benefits and risks of the surgery to remove the spinal cord, the AVM . Because the AVM is so close to the spinal cord, spinal AVM surgery is complex. To see a neurosurgeon with experience for this type of surgery.

Preparing for your appointment

You may be referred to a doctor who specializes in disorders of the brain and nervous system, known as a neurologist.

What you can do

  • Write down your symptoms, including any that may seem unrelated to the reason for which you scheduled the appointment.
  • Make a list of all your medications, vitamins and supplements.
  • Write down your key medical information, including other conditions.
  • Write down key personal information, including any recent changes or stressors in your life.
  • Write questions to ask their health professional.

Questions to ask your doctor

  • What is the most likely cause of my symptoms?
  • What kinds of tests do I need?
  • What treatments are available, and what types of side effects can I expect?
  • I have other health conditions. How can I best manage these conditions?
  • I limit my activities?

In addition to the questions that you have prepared, do not hesitate to ask questions during your appointment.

What to expect from your doctor

It is likely that he would ask several questions. Be ready to answer them may allow for more time to go over points you want to discuss in more detail. You may ask:

  • Has had problems with walking or had weakness in the legs?
  • Has had numbness, tingling, or pain in the legs?
  • Has had headaches or back pain?
  • When do you start to experience these symptoms? Have been continuous or occasional?
  • Do your symptoms get worse with exercise?
Symptoms and treatment of arteriovenous malformation (AVM)