Resumo
A case of vascular malformation on the cervico-thoracic level of spinal cord localized by selective spinal angiography is reported. The patient was treated surgically by ligadure of the "feeder" vessel. Following surgery the patient gradually improved and ten months later returned to his full activity. The diagnostic and surgical importance of spinal angiography and its contribution to the morphological study of the spinal cord vascular malformations is enphasized. Spinal angiography gives the most accurate information as to the size and extent of the malformation and also the precise location of the "feeder" vessels. Direct operation upon the spinal cord with removal or oblitations of vessels or ligadure of the feeder vessels are the best procedures. The advantages and limitations of both surgical methods are discussed. Total excision is best done under the operating microscope, being essential the use of the bipolar coagulator. The authors feel that the surgical results will be more impressive when spinal angiography will be easily available as to permit earlier diagnosis and surgery before the development of important neurological deficits.
Malformação vascular da medula cérvico-torácica diagnosticada pela angiografia de artéria intercostal tratamento cirúrgico
Cervico-thoracic vascular malformation of the spinal cord diagnosed by selective arteriography: surgical treatment. A case report
Oscar Fontenelle FilhoI; Glieb Avila PereiraII; Pedro Angelo AndreiouloIII
IChefe do Serviço de Neurocirurgia do Hospital Estadual Miguel Couto
IINeurologista do Hospital Estadual Souza Aguiar
IIIRadiologista da Clínica Emilio Amorim (Rio de Janeiro, Brasil)
SUMMARY
A case of vascular malformation on the cervico-thoracic level of spinal cord localized by selective spinal angiography is reported. The patient was treated surgically by ligadure of the "feeder" vessel. Following surgery the patient gradually improved and ten months later returned to his full activity. The diagnostic and surgical importance of spinal angiography and its contribution to the morphological study of the spinal cord vascular malformations is enphasized. Spinal angiography gives the most accurate information as to the size and extent of the malformation and also the precise location of the "feeder" vessels. Direct operation upon the spinal cord with removal or oblitations of vessels or ligadure of the feeder vessels are the best procedures. The advantages and limitations of both surgical methods are discussed. Total excision is best done under the operating microscope, being essential the use of the bipolar coagulator. The authors feel that the surgical results will be more impressive when spinal angiography will be easily available as to permit earlier diagnosis and surgery before the development of important neurological deficits.
Texto completo disponível apenas em PDF.
Full text available only in PDF format.
Hospital Estadual Miguel Couto Serviço de Neurocirurgia Rua Mario Ribeiro s/nº Rio de Janeiro. GB Brasil.
- 1. BAKER Jr., H. L.; LOVES, J. G. & LAYTON, D. D. Angiographic and surgical aspects of spinal cord vascularization. Radiology 88:1078, 1967.
- 2. Dl CHIRO, C.; COPPMAN, J. & OMMAYA, A. K. Selective arteriography of arteriovenous aneurysms of spinal cord. Radiology 88:1065, 1967.
- 3. DOPPMAN, J. & DI CHIRO, G. Subtraction angiography of spinal cord vascular malformations. Report of a case. J. Neurosurg. 23:440, 1965.
- 4. GUIDETTI, B. & FORTUNA, A. Surgical treatment of intramedullary hemangioblastoma of the spinal cord. Report of six cases. J. Neurosurg. 27: 530, 1967.
- 5. HOOK, O. & LIDVALL, H. Arteriovenous aneurysms of the spinal cord. A report of two cases investigated by vertebral angiography. J. Neurosurg. 15:84, 1958.
- 6. HOUDART, R.; DJINDJAIN, R. & HURTH, M. Vascular malformations of the spinal cord: the anatomic and therapeutic significance of arteriography. J. Neurosurg. 26:583, 1966.
- 7. KRAYENBUHL, H.; YASARGIL, M. G. & Mc CLINTOCK, H. C. Treatment of spinal cord vascular malformations by surgical excision. J. Neurosurg. 30: 427, 1969.
- 8. KUNC, Z. & BRET, J. Diagnosis and treatment of vascular malformations of the spinal cord. J. Neurosurg. 30:435, 1969.
- 9. MOYES, P. D. Intracranial and intraspinal vascular anomalies in children. J. Neurosurg. 31:271, 1969.
- 10. ODOM, G. L.; WOODHALL, B. & MARGOLIS, G. Spontaneous hematomyelia and angiomas of the spinal cord. J. Neurosurg. 14:192, 1957.
- 11. TAYLOR, J. R. & VAN ALLEN, M. M. Vascular malformation of the cord with transient ischemic attacks. A case report. J. Neurosurg. 31-576, 1969.
- 12. TENG, P. & SHAPIRO, M. J. Arterial anomalies of the spinal cord. Arch. Neurol. Psychiat. (Chicago) 80:577, 1958.
Datas de Publicação
-
Publicação nesta coleção
19 Abr 2013 -
Data do Fascículo
Set 1971
