There was focal expansion of the spinal cord at D12/L1 vertebral level (pic 1). T2
weighted images revealed a heterogenous hypointense lesion at this level (pic 2). It
appeared isointense on T1WI. These findings were consistent with acute hemorrhage
(deoxyhaemoglobin). No enhancement was noted after intravenous administration of
Vascular malformation of the spinal cord.
Brief Discussion :
Vascular malformations of the spine and spinal cord are uncommon lesions accounting for
3-11% of spinal space occupying lesions. Most are arterio-venous malformations (AVM's) or
arterio-venous fistulae.Cavernous angiomas and capillary telegictasias are less common.
Venous angiomas are rare. Pathologically, AVM's have a true nidus of pathological vessels
interposed between enlarged feeding arteries and draining veins. AVM's are of four types:
Type I : Commonest, is a dural AVF found in the dorsal aspect of the lower thoracic cord
and conus medullaris, typically affects men between their fifth and eighth decades.
Type II : AVMs are intramedullary, located dorsally in the cervico-medullary region,
mostly occuring in younger men.
Type III : Juvenile AVMs are intra medullary, and often have extra medullary / extraspinal
Type IV : are intra dural / extra medullary AVFs and usually lie anterior to the spinal
cord near the conus medullaris.
The commonest clinical presentations are paresis, sensory changes, bowel/ bladder
dysfunction, and impotence. Haemorrhage is seen in approximately 50% of cases.