CC BY 4.0 · Indian Journal of Neurosurgery 2024; 13(02): 163-166
DOI: 10.1055/s-0043-1776360
Case Report

Spinal Epidural Hematoma Caused by Pure Epidural Spinal Arteriovenous Malformation: Case Report and Literature Review

1   Academic Neurosurgery, Department of Neurosciences, University of Padova, Padova, Italy
,
Nicola Cavasin
2   Department of Neurosciences, Ospedale dell'Angelo, Mestre, VE, Italy
,
Salima Magrini
2   Department of Neurosciences, Ospedale dell'Angelo, Mestre, VE, Italy
› Author Affiliations

Abstract

Spontaneous spinal epidural hematoma (SEH) represents an extremely rare cause of spinal cord compression. Symptomatic pure extradural spinal AVMs (E-sAVM), in the absence of cavernous hemangiomas, are very rare and have rarely been reported. The clinical presentation of SEH caused by E-sAVM is often nonspecific and may lead to delayed diagnosis and treatment. We report the case of a 16-year-old adolescent girl who presented with paraparesis that rapidly evolved in paraplegia. Emergent magnetic resonance imaging (MRI) of the whole spine showed a posterior SEH, extending from C7 to T2, highly suspicious for the presence of an underlying AVM. The patient underwent emergent C7–T2 laminoplasty. An E-sAVM was intraoperatively found and subsequently excised. The patient was discharged with no neurological defects. E-sAVMs are extremely rare pathologies; they represent an extremely rare cause of spinal cord compression. If immediately diagnosed and treated, most patients recover with good prognosis.



Publication History

Article published online:
23 November 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 
  • References

  • 1 Feng Wang H, Ming Wang D. Exclusively epidural spinal arteriovenous malformation: a short review. Neuropsychiatry (London) 2017; 7 (06) 897-905
  • 2 Elkordy A, Endo T, Sato K, Sonoda Y, Takahashi A, Tominaga T. Exclusively epidural spinal metameric arteriovenous shunts: case report and literature review. Spine J 2015; 15 (03) e15-e22
  • 3 Wang HF, Lu J, Wang LJ. et al. Spinal cord ischemia and spontaneous epidural hematoma caused by spinal epidural arteriovenous malformation: a warning. Am J Emerg Med 2017; 35 (03) 519.e5-519.e9
  • 4 Rangel-Castilla L, Russin JJ, Zaidi HA. et al. Contemporary management of spinal AVFs and AVMs: lessons learned from 110 cases. Neurosurg Focus 2014; 37 (03) E14
  • 5 Paraskevopoulos D, Magras I, Polyzoidis K. Spontaneous spinal epidural hematoma secondary to extradural arteriovenous malformation in a child: a case-based update. Childs Nerv Syst 2013; 29 (11) 1985-1991
  • 6 Rispoli R, Mastrostefano R, Passalacqua G, Filauri P, Fontana M. Epidural hematoma caused by a spinal osseous epidural arteriovenous fistula in a 14-year-old patient. A case report. Neuroradiol J 2009; 22 (04) 452-457
  • 7 Sharma RR, Selmi F, Cast IP, O'Brien C. Spinal extradural arteriovenous malformation presenting with recurrent hemorrhage and intermittent paraplegia: case report and review of the literature. Surg Neurol 1994; 42 (01) 26-31
  • 8 Miyagi Y, Miyazono M, Kamikaseda K. Spinal epidural vascular malformation presenting in association with a spontaneously resolved acute epidural hematoma. Case report. J Neurosurg 1998; 88 (05) 909-911
  • 9 Cabral AJ, Barros A, Aveiro C, Vasconcelos R. Spontaneous spinal epidural haematoma due to arteriovenous malformation in a child. BMJ Case Rep 2011; 2011: bcr0220113875
  • 10 Alić F, Bečulić H, Jusić A. et al. Management of acute spontaneous thoracic spinal epidural hematoma causing paraplegia. Med Glas 2017; 14 (01) 106-110
  • 11 Yakar F, Eroğlu Ü, Doğan İ, Uğur HÇ. Pure spinal extradural arteriovenous malformation in the thoracolombar region: a case report. Eur Respir J 2018; 5 (01) 213-216
  • 12 Olivero WC, Hanigan WC, McCluney KW. Angiographic demonstration of a spinal epidural arteriovenous malformation. Case report. J Neurosurg 1993; 79 (01) 119-120
  • 13 Spetzler RF, Detwiler PW, Riina HA, Porter RW. Modified classification of spinal cord vascular lesions. J Neurosurg 2002; 96 (2, Suppl): 145-156
  • 14 Spetzler RF, Moon K, Almefty RO. eds. Handbook of Clinical Neurology. Vol. 143. Amsterdam: Elsevier; 2017: 145-152
  • 15 Muhonen MG, Piper JG, Moore SA, Menezes AH. Cervical epidural hematoma secondary to an extradural vascular malformation in an infant: Case report. Neurosurg 1995; 36 (03) 585-588
  • 16 Nadig M, Munshi I, Short MP, Tonsgard JH, Sullivan C, Frim DM. A child with neurofibromatosis-1 and a lumbar epidural arteriovenous malformation. J Child Neurol 2000; 15 (04) 273-275
  • 17 Rohany M, Shaibani A, Arafat O. et al. Spinal arteriovenous malformations associated with Klippel-Trenaunay-Weber syndrome: a literature search and report of two cases. AJNR Am J Neuroradiol 2007; 28 (03) 584-589
  • 18 Fairhall JM, Reddy R, Sears W, Wenderoth JD, Stoodley MA. et al. Successful endovascular and surgical treatment of spinal extradural metameric arteriovenous malformation: Case report. J Neurosurg Spine 2010; 13 (06) 784-788
  • 19 Sivakumaran R, King A, Bodi I, Chandler CL, Walsh DC. Spontaneous epidural spinal haematoma in children caused by vascular malformations. Europ Spine J 2016; 25: 614-618