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Thoracolumbar Arteriovenous Malformations Presenting with Intracranial Subarachnoid Hemorrhage: Case Series and Review of Literature.
World Neurosurg. 2016 Apr; 88:182-187.WN

Abstract

OBJECTIVE

Cryptogenic intracranial subarachnoid hemorrhage accounts for approximately 15% of all subarachnoid hemorrhage cases. Diagnostic workup after negative cerebral digital subtraction angiogram typically includes magnetic resonance imaging of the brain and cervical spine for arteriovenous malformations, tumors, and fistulae. Only a few cases of thoracolumbar spinal vascular malformations have been associated with intracranial subarachnoid hemorrhage.

METHODS

Case series and review of the literature.

RESULTS

We found 3 patients at our institution who had nontraumatic, nonaneurysmal intracranial subarachnoid hemorrhage with isolated spinal vascular malformation in the thoracolumbar region. Including our 3 cases, we found a total of 15 similar cases in the literature. Most of the patients were younger, most having concurrent spinal cord symptoms of radiculopathy (27%), myelopathy (20%), or bladder bowel involvement (20%). Most of the spinal vascular malformations were intramedullary or conus medullaris type. Locations of intracranial subarachnoid hemorrhage were mostly isolated to the perimesencephalic area and posterior fossa.

CONCLUSIONS

In younger populations presenting with nonaneurysmal intracranial subarachnoid hemorrhage and symptoms related to the spinal cord, evaluation for thoracolumbar spinal vascular malformations must be included in the initial workup.

Authors+Show Affiliations

Cerebrovascular Center, Cleveland Clinic, Cleveland, Ohio, USA. Electronic address: russellcerejo@gmail.com.Cerebrovascular Center, Cleveland Clinic, Cleveland, Ohio, USA.Department of Neurosurgery, Cleveland Clinic, Cleveland, Ohio, USA.Cerebrovascular Center, Cleveland Clinic, Cleveland, Ohio, USA.Cerebrovascular Center, Cleveland Clinic, Cleveland, Ohio, USA.Cerebrovascular Center, Cleveland Clinic, Cleveland, Ohio, USA.Cerebrovascular Center, Cleveland Clinic, Cleveland, Ohio, USA.Cerebrovascular Center, Cleveland Clinic, Cleveland, Ohio, USA.

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

26746332

Citation

Cerejo, Russell, et al. "Thoracolumbar Arteriovenous Malformations Presenting With Intracranial Subarachnoid Hemorrhage: Case Series and Review of Literature." World Neurosurgery, vol. 88, 2016, pp. 182-187.
Cerejo R, John S, Grabowski M, et al. Thoracolumbar Arteriovenous Malformations Presenting with Intracranial Subarachnoid Hemorrhage: Case Series and Review of Literature. World Neurosurg. 2016;88:182-187.
Cerejo, R., John, S., Grabowski, M., Bauer, A., Chaudhry, B., Toth, G., Hui, F., & Bain, M. (2016). Thoracolumbar Arteriovenous Malformations Presenting with Intracranial Subarachnoid Hemorrhage: Case Series and Review of Literature. World Neurosurgery, 88, 182-187. https://doi.org/10.1016/j.wneu.2015.12.078
Cerejo R, et al. Thoracolumbar Arteriovenous Malformations Presenting With Intracranial Subarachnoid Hemorrhage: Case Series and Review of Literature. World Neurosurg. 2016;88:182-187. PubMed PMID: 26746332.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Thoracolumbar Arteriovenous Malformations Presenting with Intracranial Subarachnoid Hemorrhage: Case Series and Review of Literature. AU - Cerejo,Russell, AU - John,Seby, AU - Grabowski,Matthew, AU - Bauer,Andrew, AU - Chaudhry,Burhan, AU - Toth,Gabor, AU - Hui,Ferdinand, AU - Bain,Mark, Y1 - 2015/12/31/ PY - 2015/09/29/received PY - 2015/12/18/revised PY - 2015/12/21/accepted PY - 2016/1/10/entrez PY - 2016/1/10/pubmed PY - 2016/8/25/medline KW - Myelopathy KW - Nonaneurysmal subarachnoid hemorrhage KW - Thoracolumbar spinal vascular malformations SP - 182 EP - 187 JF - World neurosurgery JO - World Neurosurg VL - 88 N2 - OBJECTIVE: Cryptogenic intracranial subarachnoid hemorrhage accounts for approximately 15% of all subarachnoid hemorrhage cases. Diagnostic workup after negative cerebral digital subtraction angiogram typically includes magnetic resonance imaging of the brain and cervical spine for arteriovenous malformations, tumors, and fistulae. Only a few cases of thoracolumbar spinal vascular malformations have been associated with intracranial subarachnoid hemorrhage. METHODS: Case series and review of the literature. RESULTS: We found 3 patients at our institution who had nontraumatic, nonaneurysmal intracranial subarachnoid hemorrhage with isolated spinal vascular malformation in the thoracolumbar region. Including our 3 cases, we found a total of 15 similar cases in the literature. Most of the patients were younger, most having concurrent spinal cord symptoms of radiculopathy (27%), myelopathy (20%), or bladder bowel involvement (20%). Most of the spinal vascular malformations were intramedullary or conus medullaris type. Locations of intracranial subarachnoid hemorrhage were mostly isolated to the perimesencephalic area and posterior fossa. CONCLUSIONS: In younger populations presenting with nonaneurysmal intracranial subarachnoid hemorrhage and symptoms related to the spinal cord, evaluation for thoracolumbar spinal vascular malformations must be included in the initial workup. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/26746332/Thoracolumbar_Arteriovenous_Malformations_Presenting_with_Intracranial_Subarachnoid_Hemorrhage:_Case_Series_and_Review_of_Literature_ DB - PRIME DP - Unbound Medicine ER -