Successful Spinal Arteriovenous Malformation (AVM) Treatment

By Dr. Rahul Kumar in Metro Heart Institute with Multispecialty, Faridabad

A 24 year old female patient presented to neurosurgery department with complaints of progressive
weakness and stiffness of bilateral lower limb with bowel and bladder involvement. MRI spine was
done suggestive of Cord Edema with increased T2 signal and flow void (Dorsal Spine), which raised
suspicious of AVM. DD include Trauma, Tumor, other vascular abnormalities. Patient was taken for
pre-operative spinal DSA with characterization of lesion and possible embolization of AVM. Nidus
was found at D6 vertebral body with feeder from left D8 intercostal artery.

Spinal AVM are rare form of spinal blood vessels defect that result in vessel engorgement leading I to clinical sign secondary to mass effect and Ischemia.

Ischemia is developed due to shunting of blood flow from artery to vein, leading to venous hypertension. Venous hypertension precipitate many neurological deficits including increased risk of hemorrhage.

Endovascular embolization was done of D8 intercostal artery. Post embolization, complete occlusion of spinal AVM was achieved. Following the surgery, the patient’s weakness ameliorated alongside reduced stiffness in the lower limb. The restoration of bladder sensation further contributed to the patient’s favorable recovery, resulting in a discharge within just 5 days.