Paraplégie et malformation artérioveineuse médullaire. Place de la chirurgie, de la corticothérapie et de l’embolisation

Vodoff, M.V.; Gilbert, Brigitte; Breton, F. Le; Rodesch, Georges; C, Laroche; Lagarrigue, J.; Lumley, L. De; Lasjaunias, P.

doi:10.1016/s0929-693x(00)00284-0

Cited by 5 publications

(1 citation statement)

References 5 publications

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“…eine Kombination beider Verfahren in Betracht. Vorbereitend kann eine Therapie mit Steroiden zu einer Rückbildung des Ödemes und somit klinischen Besserung führen[13]. Das therapeutische Ziel ist der komplette Verschluss der Gefäûmalformation, was allerdings nicht immer zu erreichen ist.…”

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Spinale arteriovenöse Malformation bei Klippel-Trenaunay-Weber-Syndrom: klinische Verschlechterung nach Lumbalpunktion?

Dietrich¹,

Kloss²,

Bierstedt³

2002

Akt Neurol

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Spinale arteriovenöse Malformation bei Klippel-Trenaunay-Weber-Syndrom: klinische Verschlechterung nach Lumbalpunktion?

Dietrich¹,

Kloss²,

Bierstedt³

2002

Akt Neurol

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Spinal arteriovenous malformation presenting as spastic monoplegic cerebral palsy in a child

Flett

Baulderstone²,

Russo

et al. 2012

J Paediatrics Child Health

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Abstract:A case of spinal arterio-venous malformation (AVM) initially diagnosed as unilateral cerebral palsy (CP) is reported. The presentation was of a long-standing spastic monoparesis of the left leg, with initial response to Botulinum toxin injections to the calf and tibialis posterior muscles. This was followed by progressive deterioration occurring over a 3-month period before further investigation and definitive diagnosis at 7 years. Imaging demonstrated a large extra-medullary spinal AVM compressing the mid-thoracic cord. This was successfully managed by embolisation with a non-adhesive polymer: ethylene-vinyl alcohol copolymer injected into the dominant feeding vessel. This case highlights the need to consider alternative diagnoses when a child with a diagnosis of CP presents with atypical clinical features such as monoparesis and has worsening or altered clinical signs. Moreover, a normal magnetic resonance imaging brain scan and the absence of ipsilateral upper limb neurological signs or functional impairment should raise suspicion even in the context of static lower limb signs. A literature review was performed on the management of spinal AVM in children and this will be is discussed.Key words: arterio-venous malformation; spine; cerebral palsy; child; intervention; embolisation. Case ReportA male child was born by vaginal delivery at term after a normal pregnancy. There were no neonatal complications. Normal developmental milestones were achieved, walking at 14 months of age and speaking in phrases by 2 years of age. An initial diagnosis of left hemiplegic cerebral palsy (CP) was made at 2 years of age by a paediatric neurologist on the basis of lateral circumduction and a toe strike gait pattern affecting the left leg. The left lower limb had signs of an upper motor neurone syndrome, characterised by hyper-reflexia across the knee and ankle, an up-going plantar response and some reduction in muscle bulk of the limb when compared with the non-affected side.At 5 years of age, examination of the left arm revealed a slight reduction in arm swing when walking, but otherwise there was normal muscle tone, normal deep tendon reflexes and normal function as the non-dominant upper limb. The right arm and leg were normal. Gait was not restricted; however, it was qualitatively non-fluent. The boy, however, became an accomplished break dancer, suggesting normal upper limb co-ordination and muscle strength. Vision and hearing were formally assessed and were normal. He was toilet trained, with no reported bladder or bowel problems. At 5 years, his diagnosis was revised to spastic monoplegic CP affecting only the left lower limb. A magnetic resonance imaging (MRI) of his brain was normal. Neurovasculocutaneous stigmata were not seen.Over the next 2 years, treatments were required for spasticity and an equinus deformity of the left ankle. This included botulinum toxin A injections to the calf and tibialis posterior muscles and also serial casting with good response. The outcome of these interventions was sufficient...

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Intrinsic Spinal Cord Arteriovenous Malformations

et al. 2009

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Paraplégie et malformation artérioveineuse médullaire. Place de la chirurgie, de la corticothérapie et de l’embolisation

Cited by 5 publications

References 5 publications

Spinale arteriovenöse Malformation bei Klippel-Trenaunay-Weber-Syndrom: klinische Verschlechterung nach Lumbalpunktion?

Spinale arteriovenöse Malformation bei Klippel-Trenaunay-Weber-Syndrom: klinische Verschlechterung nach Lumbalpunktion?

Spinal arteriovenous malformation presenting as spastic monoplegic cerebral palsy in a child

Intrinsic Spinal Cord Arteriovenous Malformations

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