Spinal Cord Vascular Shunts: Spinal Cord Vascular Malformations and Dural Arteriovenous Fistulas

Leodante da Costa, MD; Amir R. Dehdashti, MD; Karel G. terBrugg E, MD

Disclosures

Neurosurg Focus. 2009;26(1):E6 

In This Article

Conclusions

Spinal arteriovenous shunt is a broad term that encompasses many entities, from true arteriovenous shunts located inside the spinal cord to epidural shunts with venous drainage directed toward the spinal canal. Even within similar locations, important differentiation should be made. Spinal cord AVMs in a patient with a systemic disease such as hereditary hemorrhage telangiectasia are clearly different from sporadic spinal cord AVMs. Management should be based on the idea that preservation of function is the goal, not complete radiological cure, and understanding the basic aspects of the disease will help to differentiate between patients in whom treatment is advised and patients in whom only more harm can be done. We favor classifications that allow us to consider all the aspects involved in each lesion instead of grouping lesions into artificial categories, which, as demonstrated recently by Geibprasert et al.,[24] can impair our ability to recognize differences that can be crucial for proper management.

Comments

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