Angiodysgenetische nekrotisierende Myelopathie

Jellinger, K. A.; Minauf, M.; Garzuly, Ferenc; Neumayer, E

doi:10.1007/bf00404472

Cited by 23 publications

(16 citation statements)

References 42 publications

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“…Slowing of circulation, darker-colored vessels, and partial thrombosis giving the impression of a venous origin may cause difficulties in the in vivo separation of arteries and veins during surgery. The histological distinction between arterial and venous channels may be virtually impossible because of the severe structural abnormalities of the vessel walls [1,121,124]. Some degree of varicosity is often observed over the lower segments of the cord ( Figure 6A), and morphometric studies in large post-mortem series of aged humans revealed increased calibre and tortuousity of intradural veins over the posterior surface of the lumbosacral cord [119].…”

Section: Morphologic Typesmentioning

confidence: 98%

“…There are sometimes large or many small abnormal vessels inside the spinal cord which resemble capillary telangiectasias, or venous angiomas [218,219], and rarely, AVMs [3,73,124]. These thickwalled vascular channels have the size and position usually suggesting that they are altered capillaries or veins and, less often, arteries.…”

Section: Morphologic Typesmentioning

confidence: 98%

“…Rare intramedullary telangiectasias are isolated with preference to the posterior columns or spread rather diffuse [91]. When occuring in association with intradural AVMs, a strict distinction between true vascular malformations and secondary lesions may be difficult [124,132].…”

Section: Capillary Telangiectasiasmentioning

confidence: 99%

“…The least frequent angiographic typeI are simple AV fistulas, a single coiled vessel characterized by one or two tighly coiled continuous vessels along a large longitudinal section of the cord (Figure 6A), and the recognition of the inchanging from arterial to venous character is difficult even by histological analysis of the specimen, due to the grossly changes structures and reactive changes of the vessels [1,121,124,192]. This type of simple AV communications obviously represents the large majority of spinal vascular abnormalities previously referred to as "spinal varicosis" [138,209].…”

Section: Morphologic Typesmentioning

confidence: 99%

“…In uncomplicated cases there is usually no calcification, gliosis or hemosiderin deposit. Histologically, an absence of arteries in the malformations is necessary for the diagnosis, although the distinction between arterial and venous channels may be virtually impossible because of severe structural abnormalities of the vessel walls [124]. The differentiation of cavernomas from telangiectasias may require an integrated study of the anatomic lesion together with the angiographic and scintigraphic patterns [11@ Venous malformations may involve all parts of the C.N.S.…”

Section: Venous Malformationsmentioning

confidence: 99%

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Vascular malformations of the central nervous system: A morphological overview

Jellinger

1986

Neurosurg. Rev.

245

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Vascular malformations of the central nervous system (C.N.S.) are classified by size, location, and morphologic type, distinguishing capillary telangiectasias, cavernous malformations, venous angiomas, arteriovenous malformations (AVMs) including varix of the great vein of Galen, and other vascular malformations (e.g. Sturge-Weber syndrome). The morphology and predominant location pattern of the different types of vascular malformations in the brain and spinal cord, and their embryology are reviewed. In the brain and its coverings, all types mainly AVMs and venous angiomas do occur, representing 5-9% of all intracranial space-occupying lesions and 20-40% of the sources of surgically treated intracranial hemorrhages. 50-80% of the angiomas are located in the cerebral hemispheres, 10-18% in central brain areas (basal ganglia, internal capsule, choroid plexus), and 10-30% in the posterior fossa. The major types of cerebral vascular malformations are described with reference to their anatomical features, location, chief arterial and venous supply, and prominent complications. Spinal vascular malformations, accounting for 3 to 12% of spinal space-occupying lesions, include vertebral, extradural, dural, subpial and intramedullary angiomas which occur as isolated or complex vascular anomalies and may involve various covering layers at the same level. The preferential occurrence of angiomas on the dorsal surface of the cord and in the caudal regions is related to the embryologic development of spinal vasculature. Frequent association of spinal angiomas (20-25%) with other vascular anomalies and dysplasias emphasizes their hamartomatous nature and developmental origin. Spinal angiomas include capillary telangiectasias with extra- or intradural and, rarely, intramedullary location, cavernomas, mainly arising in vertebral bodies, venous angiomas, mainly located in vertebral bodies and in the extradural space, and AVMs constituting the commonest type, that may affect both the pial and radicular vessels and can penetrate into the cord. They present as simple AV fistulas, cirsoid angiomas with localized vascular plexuses and large complex convolutions ("juvenile" type). The complications of spinal angiomas include subarachnoid hemorrhage, rare epidural hematoma, hematomyelia, compression lesions of the cord and roots, and ischemic changes causing chronic progressive radiculomyelopathy, previously referred to as Foix-Alajouanine syndrome. Chronic damage to the cord and spinal roots results from pressure effects, thrombosis of the abnormal vessels, disorders of venous drainage, and "steal" phenomena related to the vascular anomalies.

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Section: Morphologic Typesmentioning

confidence: 98%