Spinal Vascular Disease

Question 1

What is the most common location for aneurysms in the spine?

Answer 1

ASA in the cervical or thoracic spine

Question 2

What is the difference between an AVM and an AVF?

Answer 2

AVM has true nidus, AVF does not

Question 3

What is the most frequent spinal AVM?

Answer 3

AVF

Question 4

Where is the most common location for type 1 spinal AVMs?

Answer 4

dorsal lower thoracic or upper lumbar spine

Question 5

What defines a type 1 spinal AVM?

Answer 5

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

Question 6

Symptoms from type 1 spinal AVMs are generally caused by _____.

Answer 6

venous hypertension

Question 7

A good surgical outcomes is achieved in _____ percent of type 1 spinal AVMs.

Answer 7

88%

Question 8

What are the pressures and flows for all types of spinal AVMs?

Answer 8

Type 1: low pressure, low flow

Type 2: high flow, high pressure

Type 3: high flow, high pressure

Type 4: low pressure, high flow

Question 9

Which type of spinal AVM is associated with aneurysm?

Answer 9

type 3 juvenile

Question 10

What defines a type 2 (glomus) spinal AVM?

Answer 10

congenital; intramedullary with multiple feeders draining into a venous plexus around the cord

Question 11

Where are type 2 (glomus) spinal AVMs usually located?

Answer 11

dorsal cervicomedullary

Question 12

What defines a type 3 (juvenile) spinal AVM?

Answer 12

congenital; involves entire cross section of the cord

large intramedullary and extramedullary malformation with multiple extrapinal feeders; bidirectional venous drainage

Question 13

A good surgical outcomes is obtain in _____ perfect of type 3 (juvenile) spinal AVMs.

Answer 13

50%

Question 14

What defines a type 4 spinal AVM?

Answer 14

intradural/extramedullary AVF; congenital

anterior to spinal cord fed by ASA

Question 15

Where are type 4 spinal AVMs usually located?

Answer 15

near the conus

Question 16

Which spinal AVMs are acquired? Which are congential?

Answer 16

Acquired: type 1

Congenital: types 2, 3, 4

Question 17

What is Foix Alajouanine syndrome?

Answer 17

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

Question 18

What is Klippel Trenaunay Weber syndrome?

Answer 18

spinal cord AVM with a cutaneous vascular nevus and an enlarged finger or upper limb (if cervical)

Question 19

Cav mal in the spine is usually located in the _____ spine.

Answer 19

thoracic

Question 20

Which region of the spinal cord is most often affected in spinal cord stroke?

Answer 20

mid thoracic

Question 21

What is decompression sickness? What is the classic neurologic spinal presentation?

Answer 21

Intravascular accumulation of N2 with vessel obstruction

frequently causes spinal cord dysfunction in the posterior columns of the thoracic cord