P255 - Spinal vascular malformations: experience of our institution
Serviço de Neurocirurgia, Centro Hospitalar Lisboa Central.
Introduction: Spinal vascular malformations, although rare, cause devastating disease. These malformations are commonly categorized as follows: spinal arteriovenous malformations, dural arteriovenous fistulas, spinal hemangiomas, cavernous angiomas, and aneurysms. Spinal dural arteriovenous fistulas, or type 1 arteriovenous malformations, occur most frequently, representing 60 to 80% of vascular malformations of the spinal cord.
Objectives: The aim is to present our experience in the microsurgery and endovascular management of this disease.
Material and methods and results: We did a retrospective study of patients with the diagnosis of spinal vascular malformations in the last 5 years in our department. We analysed three groups: 1 – control group (wait and scan approach); 2- microsurgery group; 3- endovascular group. We determined the differences between them in terms of demographic characteristics, presentation, location, disability grade pre/pos treatment, and complications.
Conclusions: Spinal dural arteriovenous fistulas are the most frequent malformation in our department. Is a connection between a radicular artery and a radicular vein, resulting in venous hypertension and obstruction of the venous flow. Consequently, oedema forms beneath the fistula and congestive ischemia of the myelum develops. Early recognition and treatment are essential for a good prognosis.