SPINAL CORD- AVM (INTRAMEDULLARY GLOMUS TYPE)

Images

Sag T2W

T1 C+

T1W


Clinical History:

progressive b/l lower limbs weakness


Findings:

Complex intramedullary signal abnormalities with localized cord expansion is seen at D11-D12 level.
Multiple tortous intradural flow voids are also seen.
Post c+ study reveals patchy/focal enhancement of intramedullary,intradural vessels and intense enhancement of intramedullary nidus.


Diagnosis:

SPINAL CORD AVM TYPE -II WITH CORD MYELOPATHY


Discussion:

Type 2: Referred to as a glomus AVM, type 2 malformations consist of a tightly compacted group of arterial and venous vessels (nidus) inside a short segment of the spinal cord. The abnormal vessels are intramedullary in location. These lesions usually present in younger patients with acute neurologic deterioration secondary to their location, which is usually the dorsal cervicomedullary region. The mortality rate related to type 2 malformation is reported at 17.6%. After initial hemorrhage, the rebleed rate is 10% within the first month and 40% within the first year.


References / Suggested Reading:

1.Caragine LP, Halbach VV, Ng PP, Dowd CF (June 2002). "Vascular myelopathies-vascular malformations of the spinal cord: presentation and endovascular surgical management". Semin Neurol 22 (2): 123-32


Author

ANSHU

RESIDENT

ACHARYA SHRI CHANDER COLLEGE OF MEDICAL SCIENCES & HOSPITAL