Type IV spinal vascular malformation

Introduction to type IV spinal vascular malformation Type IV spinal vascular malformation is an epidural spinal cord arteriovenous fistula, and its lesion is essentially an arteriovenous fistula supplied directly from the anterior spinal artery in the dura. Arteriovenous fistula and its reflux vein are located outside the spinal cord, and the lesion does not spread into the spinal cord. This type is divided into three subtypes of IVA, IVB, and IVC. These lesions are composed of intramedullary arteries (or occasionally the posterior spinal artery) and hard. The blood vessels in the intra-membrane reflux vein are directly anastomosed. Most of these patients are younger. This type of spinal vascular malformation is suitable for endovascular treatment or microsurgical treatment, or a combination of the two. basic knowledge The proportion of illness: the incidence rate is about 0.0001% - 0.0003% Susceptible people: no special people Mode of infection: non-infectious Complications: radiation-induced myelopathy, paraneoplastic myelopathy, hepatic myelopathy

The cause of type IV spinal vascular malformation

This type of lesion is essentially an arteriovenous fistula supplied directly from the anterior spinal artery in the dura. Arteriovenous fistula and its reflux vein are located outside the spinal cord, and the lesion does not spread into the spinal cord.

Type IV spinal vascular malformation prevention

Prevention: There is no effective prevention method for this disease.

Type IV spinal vascular malformation complications Complications, radiation, myelopathy, paraneoplastic myelopathy, hepatic myelopathy

Most patients can have progressive myelopathy.

Type IV spinal vascular malformation symptoms common symptoms sensory impairment motor dysfunction venous thrombosis vascular malformation

1. Clinical features

Most of the patients are younger, and there is no difference in the proportion of males and females. Symptoms often occur before the age of 40. The incidence rate is about 1/6 of all cases, and half of them are IVA patients. Most of the patients show progressive myelopathy. With pain, weakness and sensory and sphincter dysfunction, or subarachnoid hemorrhage.

The spinal cord function of these patients is similar to that of type I spinal cord vascular malformation. The vascular congestion is caused by the increase of intradural venous pressure. The IVC type affects the function of the spinal cord and nerve roots due to the extensive lesions causing oppression. The patient may have occurred the day after tomorrow.

2. Classification

(1) Type IVA: There is only a single nourishing artery or a relatively slow, moderately thin intradural vein.

(2) Type IVB: characterized by multiple nourishing arteries with large reflux veins and more blood flow.

(3) IVC type: The lesions are large in scope, and there are often multiple nourishing arteries. These arteries flow back into the dilated veins in the dura.

This type of case is generally considered rare, but Barrow and colleagues report that type IV lesions account for 17% of spinal cord vascular malformations treated at the medical center where they are located.

Examination of type IV spinal vascular malformation

Selective angiography can show the distribution of the anterior spinal artery to the arteriovenous fistula and the reflux vein, sometimes showing large signs of airflow around the spinal cord, mainly manifested by the expansion of the obvious epidural venous return. These deformities often appear in the thoracolumbar connection. Near the cone and near the end of the horse's tail.

Diagnosis and diagnosis of type IV spinal vascular malformation

Mainly based on medical history, signs and imaging examinations.

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