Thoracolumbar Arteriovenous Malformations Presenting with Intracranial Subarachnoid Hemorrhage: Case Series and Review of Literature

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• 作者：Russell Cerejo¹ ; ^{russellcerejo@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Seby John¹ ; Matthew Grabowski² ; Andrew Bauer¹ ; Burhan Chaudhry¹ ; Gabor Toth¹ ; Ferdinand Hui¹ ; Mark Bain¹
• 关键词：Myelopathy ; Nonaneurysmal subarachnoid hemorrhage ; Thoracolumbar spinal vascular malformations
• 刊名：World Neurosurgery
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：88
• 期：Complete
• 页码：182-187
• 全文大小：3882 K

文摘

Cryptogenic intracranial subarachnoid hemorrhage accounts for approximately 15% of all subarachnoid hemorrhage cases. Diagnostic workup after negative cerebral digital subtraction angiogram typically includes magnetic resonance imaging of the brain and cervical spine for arteriovenous malformations, tumors, and fistulae. Only a few cases of thoracolumbar spinal vascular malformations have been associated with intracranial subarachnoid hemorrhage.

Methods

Case series and review of the literature.

Results

We found 3 patients at our institution who had nontraumatic, nonaneurysmal intracranial subarachnoid hemorrhage with isolated spinal vascular malformation in the thoracolumbar region. Including our 3 cases, we found a total of 15 similar cases in the literature. Most of the patients were younger, most having concurrent spinal cord symptoms of radiculopathy (27%), myelopathy (20%), or bladder bowel involvement (20%). Most of the spinal vascular malformations were intramedullary or conus medullaris type. Locations of intracranial subarachnoid hemorrhage were mostly isolated to the perimesencephalic area and posterior fossa.

Conclusions

In younger populations presenting with nonaneurysmal intracranial subarachnoid hemorrhage and symptoms related to the spinal cord, evaluation for thoracolumbar spinal vascular malformations must be included in the initial workup.