Wednesday, January 26, 2011

Progressive myelopathy caused by vascular malformations

Progressive myelopathy caused by vascular malformations Arteriovenous malformations (AVM) of the spinal cord usually meet at the upper thoracic or lumbar. MAV occurs in the dura, the spinal posterior face. These defects can be seen in the neck or upper chest, especially being located in front of the marrow and can often bleed. Progressive myelopathy caused by vascular malformations occurs in older people, being predominantly male.
Clinic Pain patient presents with progressive myelopathy and radicular nature. Neurological examination found most often sensitive disorders, motor and sphincter disorders. Disorders may be the main motor, producing a combination of central and peripheral motor neuron, which can lend itself to confusion with ankylosing spondylitis. Patients can present with intermittent claudication. Claudication is leg pain that occurs after the patient went through a certain distance, up to 300-400 meters and disappears at rest. To meet cases of acute exacerbation of simtomatologiei and deterioration in the situation of bleeding into the spinal cord or subarachnoid space. Myelopathy may have a slow or fast, but we may also encounter patients in apparent remission.
The syndrome Foix-Alajouanine progressive thoracic myelopathy is accompanied by numbness which develop within weeks or months and meet abnormally thick vessels.
Diagnosis The clinical examination can be seen in the spine a vascular lesion, a lipoma or discoloration of the skin. Sometimes it can meet this level of vascular murmurs. Diagnosis is based on MRI imaging (magnetic resonance imaging) with CT myelography and contrast material. To confirm the diagnosis of selective spinal angiography is required to provide information on the size of the malformation and collateral vessels.
Treatment is surgical. Embolization is performed with occlusion of major collateral vessels. By this maneuver many patients can recover neurological deficits.

No comments:

Post a Comment