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Onyx embolization of a thoracolumbar perimedullary spinal arteriovenous fistula in an infant presenting with subarachnoid and intraventricular hemorrhage.
J Neurosurg Pediatr. 2009 Mar; 3(3):211-4.JN

Abstract

Identifying a source of spontaneous subarachnoid hemorrhage (SAH) or intraventricular hemorrhage (IVH) in patients with negative results on cranial angiographic imaging can be a diagnostic challenge. The authors present the case of a 14-month-old girl who presented with lethargy and spontaneous SAH and IVH, and later became acutely paraplegic. Except for the SAH and IVH, findings on neuroimages of the brain were normal. Magnetic resonance imaging revealed an intramedullary thoracolumbar spinal cord hemorrhage that was found to be associated with arterialized veins intraoperatively. Catheter-based diagnostic angiography identified a spinal perimedullary macroarteriovenous fistula (macro-AVF) that was completely embolized with Onyx, negating the need for further surgical intervention. The authors believe this to be the first reported case of a thoracolumbar perimedullary macro-AVF presenting with SAH and IVH. In addition, descriptions of Onyx embolization of a spinal AVF in the literature are rare, especially in pediatric patients.

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Authors+Show Affiliations

Kenning TJ
Division of Neurosurgery, Department of Surgery, Albany Medical Center, Albany, New York 12208, USA. kennint@mail.amc.edu
Deshaies EM
No affiliation info available
Adamo MA
No affiliation info available
Waldman JB
No affiliation info available
Boulos AS
No affiliation info available

MeSH

Arteriovenous FistulaCerebral HemorrhageDimethyl SulfoxideEmbolization, TherapeuticFemaleHumansInfantPolyvinylsSpinal Cord DiseasesSubarachnoid Hemorrhage

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

19338467

Citation

Kenning, Tyler J., et al. "Onyx Embolization of a Thoracolumbar Perimedullary Spinal Arteriovenous Fistula in an Infant Presenting With Subarachnoid and Intraventricular Hemorrhage." Journal of Neurosurgery. Pediatrics, vol. 3, no. 3, 2009, pp. 211-4.
Kenning TJ, Deshaies EM, Adamo MA, et al. Onyx embolization of a thoracolumbar perimedullary spinal arteriovenous fistula in an infant presenting with subarachnoid and intraventricular hemorrhage. J Neurosurg Pediatr. 2009;3(3):211-4.
Kenning, T. J., Deshaies, E. M., Adamo, M. A., Waldman, J. B., & Boulos, A. S. (2009). Onyx embolization of a thoracolumbar perimedullary spinal arteriovenous fistula in an infant presenting with subarachnoid and intraventricular hemorrhage. Journal of Neurosurgery. Pediatrics, 3(3), 211-4. https://doi.org/10.3171/2008.12.PEDS0870
Kenning TJ, et al. Onyx Embolization of a Thoracolumbar Perimedullary Spinal Arteriovenous Fistula in an Infant Presenting With Subarachnoid and Intraventricular Hemorrhage. J Neurosurg Pediatr. 2009;3(3):211-4. PubMed PMID: 19338467.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Onyx embolization of a thoracolumbar perimedullary spinal arteriovenous fistula in an infant presenting with subarachnoid and intraventricular hemorrhage. AU - Kenning,Tyler J, AU - Deshaies,Eric M, AU - Adamo,Matthew A, AU - Waldman,John B, AU - Boulos,Alan S, PY - 2009/4/3/entrez PY - 2009/4/3/pubmed PY - 2009/4/22/medline SP - 211 EP - 4 JF - Journal of neurosurgery. Pediatrics JO - J Neurosurg Pediatr VL - 3 IS - 3 N2 - Identifying a source of spontaneous subarachnoid hemorrhage (SAH) or intraventricular hemorrhage (IVH) in patients with negative results on cranial angiographic imaging can be a diagnostic challenge. The authors present the case of a 14-month-old girl who presented with lethargy and spontaneous SAH and IVH, and later became acutely paraplegic. Except for the SAH and IVH, findings on neuroimages of the brain were normal. Magnetic resonance imaging revealed an intramedullary thoracolumbar spinal cord hemorrhage that was found to be associated with arterialized veins intraoperatively. Catheter-based diagnostic angiography identified a spinal perimedullary macroarteriovenous fistula (macro-AVF) that was completely embolized with Onyx, negating the need for further surgical intervention. The authors believe this to be the first reported case of a thoracolumbar perimedullary macro-AVF presenting with SAH and IVH. In addition, descriptions of Onyx embolization of a spinal AVF in the literature are rare, especially in pediatric patients. SN - 1933-0707 UR - https://www.unboundmedicine.com/medline/citation/19338467/Onyx_embolization_of_a_thoracolumbar_perimedullary_spinal_arteriovenous_fistula_in_an_infant_presenting_with_subarachnoid_and_intraventricular_hemorrhage_ L2 - https://thejns.org/doi/10.3171/2008.12.PEDS0870 DB - PRIME DP - Unbound Medicine ER -