Arteriovenous malformations (AVM) are abnormally formed blood vessels that can be located
throughout the brain and spinal cord. Patients with abnormalities of the blood vessels
located in and around the spinal cord can develop many neurological problems. Some problems
include, weakness, pain, difficulty walking, paralysis, and even death.
The treatment for these AVMs depends on their location, the type of malformation, the area
of the spine involved, and the condition of the patient at the time of treatment. The
treatment is aimed at stopping the neurologic problems from worsening and possibly
correcting the existing problems. There are two commonly used treatments for AVMs, surgery
and embolization (blocking off of blood flow to the AVM).
However, researchers have limited experience treating these conditions because they are
rare. In addition, it has been difficult to classify different kinds of AVMs and to develop
new treatments for them.
This study is designed to increase researchers understanding of AVMs by admitting and
following patients diagnosed with the condition. By increasing the amount of patients
studied diagnosed with spinal blood vessel abnormalities, researchers can begin to develop
new management plans for patients with AVMs.
Spinal Arteriovenous Malformations are rare lesions that frequently effect young patients
and adults in their most productive years. They cause progressive myelopathy, ultimately
causing paraplegia or quadriplegia if untreated. Because they are rare lesions, experience
with treating them in sufficient numbers to permit classification of them, investigation of
the pathophysiology of myelopathy, and the introduction of new techniques for treatment has
been possible in only a very few centers in this country. One essential element of
investigation of them is selective spinal arteriography. Since selective spinal
arteriography was first introduced for these lesions here at the NIH in the mid 1960's by
Drs. John Doppman and Giovanni DiChiro, the NIH has been such a center of expertise for
patients with spinal arteriovenous malformations. Because of this, NIH has been, and is, a
national referral center for these patients. However, there has never been an approved
protocol at the NIH for investigation or treatment of these patients. The purpose of this
proposal is to present a plan of investigation and treatment which will serve as a protocol
under which to admit these patients and to permit continued accrual of clinical experience
with them that will serve to guide others in the management of these patients.
- INCLUSION CRITERIA:
Adult greater than or equal to 18 years with known or suspected spinal AVM and capacity to
provide written informed consent.
Child ages 4-18 with known or suspected spinal AVM and with parent/guardian informed
Unable to tolerate MRI and/or spinal arteriography.
Child less than 4 years.