A spinal arteriovenous malformation (AVM) is a tangle of blood vessels in the spine that can grow large enough to cause symptoms like pain and paralysis. These vascular abnormalities are relatively rare in the general population and usually start to cause symptoms in adults between the ages of 20 and 60. Treatment options are available once a doctor identifies a growth and collects information about the size and scope of the abnormality. This may be time sensitive in the case of large and fragile AVMs, where treatment is necessary as soon as possible to reduce the risk of severe complications.
In a dural spinal arteriovenous malformation, the veins grow in and around the tough membrane known as the dura that normally covers the spinal cord. Intradural growths are on the outside, while intramedullary growths are positioned inside the spinal cord itself. As the blood vessels grow, there is also a risk of causing a fistula, an abnormal connection between the arteries and the dura, which can cause additional medical problems.
The reasons why spinal arteriovenous malformations develop are unclear. Patients may start to notice neurological symptoms like intermittent pain, paralysis, and weakness. Over time, these become more consistent as the vessels grow and put pressure on the spinal cord and nerves. There is a risk the growth could rupture, causing internal bleeding and a host of complications. Treatment is necessary to address the growth once it is discovered, and the patient may also need follow-up care to check for signs of recurrence and other issues.
A doctor can request a medical imaging study to locate a spinal arteriovenous malformation and determine the best approach to treatment. One option is endovascular embolization, where the doctor carefully feeds a catheter through the involved blood vessels and blocks off the blood supply to the AVM so it cannot continue to grow. Another choice is surgery to remove the vessels, which may be necessary in the case of a complex or delicate malformation.
Neurologists usually provide evaluation and treatment for a patient with a spinal arteriovenous malformation. Patients may find it helpful to visit a doctor for a second opinion to learn more about the options. Treatment of vascular abnormalities is constantly evolving, and some doctors may be more familiar with the newest treatments than others. A second opinion could also provide information about clinical trials and other options for spinal arteriovenous malformation treatment that patients may want to consider.
