Spinal Vascular Disease Flashcards
What is the most common location for aneurysms in the spine?
ASA in the cervical or thoracic spine
What is the difference between an AVM and an AVF?
AVM has true nidus, AVF does not
What is the most frequent spinal AVM?
AVF
Where is the most common location for type 1 spinal AVMs?
dorsal lower thoracic or upper lumbar spine
What defines a type 1 spinal AVM?
actually a dural AVF; single transdural arterial feeder that goes to an intradural arterialized vein over multiple
segments
usually rostral venous drainage
nidus is in or adjacent to the dura around a nerve root
Symptoms from type 1 spinal AVMs are generally caused by _____.
venous hypertension
A good surgical outcomes is achieved in _____ percent of type 1 spinal AVMs.
88%
What are the pressures and flows for all types of spinal AVMs?
Type 1: low pressure, low flow
Type 2: high flow, high pressure
Type 3: high flow, high pressure
Type 4: low pressure, high flow
Which type of spinal AVM is associated with aneurysm?
type 3 juvenile
What defines a type 2 (glomus) spinal AVM?
congenital; intramedullary with multiple feeders draining into a venous plexus around the cord
Where are type 2 (glomus) spinal AVMs usually located?
dorsal cervicomedullary
What defines a type 3 (juvenile) spinal AVM?
congenital; involves entire cross section of the cord
large intramedullary and extramedullary malformation with multiple extrapinal feeders; bidirectional venous drainage
A good surgical outcomes is obtain in _____ perfect of type 3 (juvenile) spinal AVMs.
50%
What defines a type 4 spinal AVM?
intradural/extramedullary AVF; congenital
anterior to spinal cord fed by ASA
Where are type 4 spinal AVMs usually located?
near the conus
Which spinal AVMs are acquired? Which are congential?
Acquired: type 1
Congenital: types 2, 3, 4
What is Foix Alajouanine syndrome?
Subacute necrotizing myelitis, especially in the gray matter, usually with a type 1 AVM, and caused by venous hypertension
presents as spastic and then flaccid paraplegia
with an ascending sensory loss and loss of sphincter control
What is Klippel Trenaunay Weber syndrome?
spinal cord AVM with a cutaneous vascular nevus and an enlarged finger or upper limb (if cervical)
Cav mal in the spine is usually located in the _____ spine.
thoracic
Which region of the spinal cord is most often affected in spinal cord stroke?
mid thoracic
What is decompression sickness? What is the classic neurologic spinal presentation?
Intravascular accumulation of N2 with vessel obstruction
frequently causes spinal cord dysfunction in the posterior columns of the thoracic cord
