What is Spinal AVM or Spinal Arteriovenous Malformation?

Spinal AVM or Spinal Arteriovenous Malformation is a very uncommon and unnatural tangling of the blood vessels in the spinal cord or near/on the spinal cord. If left untreated, Spinal AVM or Spinal Arteriovenous Malformation can be the reason of permanent damage to your spinal cord.

Spinal Arteriovenous Malformation

Blood carrying the oxygen enters the spinal cord through the arteries present in the blood vessels. These further divide in to capillaries which are smaller blood vessels. Spinal cord uses this supplied oxygen from the capillaries and passes it to the heart and lungs through blood. During the condition of Spinal AVM or Spinal Arteriovenous Malformation, blood tends to directly pass to the veins from the arteries and do not take the way of capillaries (ie, bypassing the capillaries).

This is the prime reason behind the demolition of the spinal tissue cells. Under such syndrome, the arteries and veins rupture causing hemorrhage in the spinal cord. The spinal cord gets compressed due to such bleeding and the increased size of AVM.

Unless there are strong indications of Spinal AVM or Spinal Arteriovenous Malformation in the body externally, you may miss out on the symptoms and signs. A prompt surgery may be effective in reversing the process and recovery from a portion of the damage caused to the spinal cord.

Epidemiology of Spinal AVM or Spinal Arteriovenous Malformation

Persons from any age from 20 years to 80 years can get affected by Spinal AVM or Spinal Arteriovenous Malformation.

Clinical Presentation of Spinal AVM or Spinal Arteriovenous Malformation

Spinal AVM or Spinal Arteriovenous Malformation is irregular and shifting in nature. It ranges from the progressive myelopathy (Foix-Alajouanine syndrome) which is tough to apparently diagnose, to the catastrophic spinal subarachnoid hemorrhage.

Causes of Spinal AVM or Spinal Arteriovenous Malformation

There is no prime cause of Spinal AVM or Spinal Arteriovenous Malformation yet found out by medical professionals. However in some case it may be congenital, that means the person can be affected from this syndrome since birth. Researchers are yet to be sure on the reasons.

Classification of Spinal AVM or Spinal Arteriovenous Malformation

Spinal AVM or Spinal Arteriovenous Malformationcan be categorized in the following ways:

  • Intramedullary Spinal AVM or Spinal Arteriovenous Malformation.
  • Extramedullary Spinal AVM or Spinal Arteriovenous Malformation.

Also the Spinal AVM or Spinal Arteriovenous Malformation can be divided into the below alternative four types:

  • Single coiled vessel also known as Dural AV fistula (Type 1)
  • Intramedullary glomus AVM (Type 2)
  • Juvenile Spinal AVM or Spinal Arteriovenous Malformation (Type 3)
  • Intraduralperimedullary or the AV fistula (Type 4)

Type 4 of Spinal AVM or Spinal Arteriovenous Malformation which is "Intraduralperimedullary", can be further categorized as per its nature in the following three sub types:

  • Sub type 1: This falls under the following
    • ASA or Single arterial supply
    • SSF or Single small fistula
    • SAPVD or Slow ascending perimedullary venous drainage
  • Sub type 2: This falls under the following:
    • Multiple or Numerous arterial supply called ASA & PSA
    • Multiple or Numerous intermediate fistulae
    • Slow rising perimedullary venous seepage or drainage
  • Sub type 3: This falls under the following:
    • Multiple arterial supply called ASA and PSA
    • Single giant fistula
    • Large ectatic venous seepage or drainage.

Signs and Symptoms of Spinal AVM or Spinal Arteriovenous Malformation

People affected with Spinal AVM or Spinal Arteriovenous Malformation do not show any significant signs and symptoms and this is the reason of delayed diagnosis or no diagnosis at all. The symptoms however are different in different age and position of the Spinal AVM or Spinal Arteriovenous Malformation. Most people are diagnosed with Spinal AVM below the age of 16. However, as discussed above any person can be affected by this syndrome irrespective of their sex till the age of 80.

At the primary stage of Spinal AVM or Spinal Arteriovenous Malformation, the symptoms at once are noticed. These could be:

  • Trouble in climbing stairs or even walking.
  • Sudden pain in your legs with ticklish or numb feeling.
  • Weakness in any or every part of the body.

At the later stage of Spinal AVM or Spinal Arteriovenous Malformation as the disease progresses, additional symptoms which are noticed are:

  • No sense in the lower part of the body
  • This results in difficulty in passing urine and moving bowels
  • Pain in the lower back
  • Stiff neck
  • Sensitive response to light
  • Headache.

Do not waste any time as you experience any signs or indications of Spinal AVM or Spinal Arteriovenous Malformation. An early diagnosis is always better in any medical condition.

Risk Factors for Spinal AVM or Spinal Arteriovenous Malformation

All the risk factors for Spinal AVM or Spinal Arteriovenous Malformation are unknown and cannot be categorized. However both men and women experience same risk.

Complications for Spinal AVM or Spinal Arteriovenous Malformation

If gone undiagnosed and uncured, spinal arteriovenous malformations, it can turn in to vital disability in a person as it slowly progresses inside the body. The specific obstacles are:

  • Motor deficits or trouble in moving.
  • Sensory deficits or constant pain or numbness in the body.
  • Spinal column deformity.
  • Bulging blood vessel (aneurysm).
  • Venous hypertension i.e., high blood pressure causing accumulation of fluid (edema) and loss of live tissue in the absence of oxygen, also known as spinal cord infarction.
  • Hemorrhage or excessive internal bleeding causing damage to the spinal cord in a faster rate.

Getting Ready for the Consulting a Specialist for Spinal AVM or Spinal Arteriovenous Malformation

A neurologist should be consulted for such syndrome as they specialize in disorders related to nervous system and brain.

Things to do Before Consulting the Doctor for Spinal AVM or Spinal Arteriovenous Malformation

  • Make a list of the signs and symptoms you find in you.
  • Make a list of the medicines you currently intake along with all other supplements.
  • Make a list of all changes you notice in your body.
  • Make a list of the behavioral changes people have found in you during this time or maybe you have noticed.
  • Make a list of your queries.

Queries to Ask your Doctor About Spinal AVM or Spinal Arteriovenous Malformation

  • Causes of the symptoms in your body and behavior.
  • Tests to be undergone.
  • Expected treatment procedure.
  • Other tendencies of further complications.
  • Restrictions to follow.

Do not hesitate to ask for any other query which you may have in your mind.

Expectations from the Doctor for Spinal AVM or Spinal Arteriovenous Malformation

The doctor may ask you the following things during the consultation session for spinal AVM or spinal arteriovenous malformation:

  • Problems related to your physical mobility.
  • Presence of any pain or numbness in the lower limbs.
  • Back pain or headaches.
  • Occurrence of these symptoms.
  • Worsening of the symptoms under any particular condition.

Tests to Diagnose Spinal AVM or Spinal Arteriovenous Malformation

Spinal AVM or Spinal Arteriovenous Malformation is always much complex to cure apparently as it does not follow any regular symptom equal to alternative spinal illnesses, such as spinal dural arteriovenous fistula, multiple sclerosis, spinal cord tumor or spinal stenosis,.

Doctors however recommend the following tests to diagnose Spinal AVM or Spinal Arteriovenous Malformation:

  • MRI (Magnetic resonance imaging) to identify any formation of mass due to rare and abnormal or divergent connection of blood vessels.
  • Angiography to determine the position and characteristics of the isolated blood vessels. In this procedure a thin tube or catheter is inserted in the artery of the patient's groin which reaches the spinal cord. Even dye is sometimes injected in to the spinal cord blood vessels as they may remain invisible during the X-ray imaging otherwise.

Treatment for Spinal AVM or Spinal Arteriovenous Malformation

Surgery is very much necessary to remove the Spinal AVM or Spinal Arteriovenous Malformation from the surrounding tissues.

An endovascular embolization however may be recommended by the doctor before the surgery. This is undergone to lessen the scopes of excessive bleeding during the surgery and gradually reduces the size of AVM for a successful surgery.

During the procedure of endovascular embolization, a catheter is inserted in to the leg artery which again reaches the artery connected to the spinal cord which feeds the AVM. In order to block the artery and lessen chances of blood flow into the AVM during the surgery, tiny blue glue like substances are injected.

Radiation therapy is later carried out in some cases to reduce the lesion where the surgery cannot successfully remove the Spinal AVM or Spinal Arteriovenous Malformation.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: November 7, 2015

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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