A newborn male infant with flaccid paraplegia, without contractures, deformities or atrophy, caused by an arteriovenous malformation (AVM) of the dorsal spinal cord, is reported from the Depts Neurosurgery and Pediatrics, Hospital Infantil Nino Jesus and Dept Neuroradiology, Hospital Infantil La Paz, Madrid, Spain. Diagnosis was by lumbar puncture showing blood in the CSF, myelography demonstrating serpiginous filling defects and increased spinal cord diameter, and a spinal angiographic outline of the AVM with a large intraspinal aneurysmal sac. Following embolizations, clipping of feeding vessels, and surgical removal of the sac, the AVM was closed but the paraplegia had persisted at 10 mo follow-up. [1]
COMMENT. Spinal cord A-V malformations may be dorsal extradural, compact intraspinal or diffuse intraspinal involving several vertebral segments. The latter presents in childhood or adolescence and carries a poor prognosis. Stereotaxic radiosurgery or proton beam therapy may offer better results than surgical intervention for large AVM’s involving eloquent nervous tissue. [2]