Spinal Vascular Disorders

Spinal Vascular Malformations

A spinal arteriovenous vascular malformation (AVM) is a rare, abnormal tangle of blood vessels on, in, or near the spinal cord. In spinal AVM, the blood passes directly from the arteries to the veins, bypassing the capillaries. This disruption deprives surrounding cells of oxygen and causes the cells in the spinal tissues to deteriorate and die. The arteries and veins in a spinal AVM can also rupture and cause bleeding in the spinal cord, or the AVM can enlarge over time and compress the spinal cord. Spinal AVM can cause permanent damage to the spinal cord if left untreated, and could lead to disability or other complications.

Spinal AVM can go undiagnosed unless an individual begins to experience symptoms. Initial symptoms may include problems walking or climbing stairs, numbness, tingling, or sudden pain in the legs, or weakness on one or both sides of the body. As the condition progressions, additional symptoms may include sudden severe back pain, lack of feeling in the legs, difficulty urinating or moving the bowels, headache, stiff neck, or sensitivity to light.

Spinal Vascular Malformations: Minimally Invasive Embolization Procedures

Spinal vascular malformations occur when abnormal vessels form between arteries and veins without the normal capillary mesh that enables blood flow between them.

  • Spinal Cord
  • Bones of the Spine
  • Tissue around the Spine
  • Tissue around Spinal Cord within Spinal Canal

These malformations can be congenital, meaning present at birth, or develop over time. Some individuals do not experience any symptoms while others will experience symptoms suddenly that grow worse with time. A decrease in blood supply to the spine and nerves results in symptoms, including numbness and tingling in the legs, loss of bladder control, spinal cord stroke, sub-arachnoid hemorrhage.

The three classifications of spinal vascular malformations include:

  • Neoplastic Tumors
  • Spinal Aneurysms
  • Spinal Arteriovenous Lesions

An MRI or CT scan is often used to diagnose a spinal vascular malformation. Before treatment takes place, a spinal aniogram is conducted to get a detailed image of the blood vessels in the spine. Embolization is used to treat neoplastic tumors as well as spinal aneurysms. This minimally invasive technique uses a catheter to block the flow of blood thus shrinking the tumor or blocking the aneurysm.

Brain Tumors / Meningioma (As Part of a Multi-Disciplinary Approach with Neurosurgery)

A meningioma is a tumor that forms on membranes that cover the brain and spinal cord, just inside the skull. It gets its name from where it forms, on the three layers of membranes that are called meninges. These tumors usually grow slowly, and a large majority of them are benign. Benign meningiomas often cause no symptoms and require no immediate treatment, but their growth can cause serious problems, and in some cases be fatal. A small number of meningiomas are cancerous and tend to grow quickly, often spreading to other parts of the brain and beyond, including to the lungs.

Two well-known risk factors for meningiomas are exposure to radiation and neurofibromatosis type 2. Meningiomas have also been found in places where skull fractures have occurred or the surrounding membrane has been scarred, and some research suggests a link between meningiomas and progesterone. Middle-aged women are twice as likely as men to develop a meningioma, and they are very rare in children.

Because the growth of benign meningiomas is slow, most symptoms develop gradually, if at all, and may include headaches, seizures, blurred vision, weakness in the arms or legs, numbness, or speech problems. If the tumor is not causing any symptoms, observation will often be recommended, with regular brain scans to determine whether it is growing. If the tumor’s growth becomes a health threat or symptoms begin to develop, surgery may be necessary, depending on the meningiomas location. If the tumor isn’t accessible through surgery, or the surgeon isn’t able to remove all of it, radiation therapy may be used to shrink it or prevent it from growing.