Diagnostik und Therapie der spinalen vaskulären Malformationen

TY - JOUR

T1 - Diagnostik und Therapie der spinalen vaskulären Malformationen

T2 - Ein Update

AU - Eicker, S

AU - Turowski, B

AU - Steiger, H-J

AU - Hänggi, D

PY - 2010/6

Y1 - 2010/6

N2 - INTRODUCTION: Spinal vascular malformations are rare disease patterns with a clinical incidence of about 5-10/year/1 million comprising spinal arteriovenous malformations (sAVM), spinal arteriovenous fistulas (sAVF) and spinal cavernomas. Long courses of disease before diagnosis deteriorate the prognosis despite successful treatment.METHODS: Selective review of the literature in consideration of present guidelines.RESULTS: Spinal vascular pathological conditions can be classified into different subtypes especially by use of magnetic resonance imaging (MRI) and selective digital subtraction angiography (DSA). Diagnosis and treatment of spinal dural arteriovenous fistula (type I) as well as spinal arteriovenous malformations (type II-V) ideally require a close co-operation between neurosurgeons and neuroradiologists. Surgery can in general be considered as curative. Endovascular therapy of arteriovenous malformations results in reduction of size and concomitant haemodynamic effects. A curative approach is generally not possible. Particularly in cases of lumbosacral and craniosacral arteriovenous fistulas the interventional procedure provides advantages. Treatment of spinal cavernomas nowadays consists of neurosurgical approaches exclusively. The significance of radiosurgical therapy, especially with the CyberKnife, remains indistinct. Today, interdisciplinary neurosurgical and neuroradiological co-operation in specialized centres allows most spinal vascular malformations to be diagnosed at an early stage and to be treated with satisfying results.

AB - INTRODUCTION: Spinal vascular malformations are rare disease patterns with a clinical incidence of about 5-10/year/1 million comprising spinal arteriovenous malformations (sAVM), spinal arteriovenous fistulas (sAVF) and spinal cavernomas. Long courses of disease before diagnosis deteriorate the prognosis despite successful treatment.METHODS: Selective review of the literature in consideration of present guidelines.RESULTS: Spinal vascular pathological conditions can be classified into different subtypes especially by use of magnetic resonance imaging (MRI) and selective digital subtraction angiography (DSA). Diagnosis and treatment of spinal dural arteriovenous fistula (type I) as well as spinal arteriovenous malformations (type II-V) ideally require a close co-operation between neurosurgeons and neuroradiologists. Surgery can in general be considered as curative. Endovascular therapy of arteriovenous malformations results in reduction of size and concomitant haemodynamic effects. A curative approach is generally not possible. Particularly in cases of lumbosacral and craniosacral arteriovenous fistulas the interventional procedure provides advantages. Treatment of spinal cavernomas nowadays consists of neurosurgical approaches exclusively. The significance of radiosurgical therapy, especially with the CyberKnife, remains indistinct. Today, interdisciplinary neurosurgical and neuroradiological co-operation in specialized centres allows most spinal vascular malformations to be diagnosed at an early stage and to be treated with satisfying results.

KW - Adult

KW - Angiography, Digital Subtraction

KW - Central Nervous System Vascular Malformations

KW - Child

KW - Embolization, Therapeutic

KW - Female

KW - Hemangioma, Cavernous, Central Nervous System

KW - Humans

KW - Image Processing, Computer-Assisted

KW - Magnetic Resonance Imaging

KW - Male

KW - Patient Care Team

KW - Practice Guidelines as Topic

KW - Prognosis

KW - Radiosurgery

KW - Spinal Cord

KW - Spinal Cord Neoplasms

KW - Treatment Outcome

KW - Young Adult

U2 - 10.1007/s00115-010-2971-2

DO - 10.1007/s00115-010-2971-2

M3 - SCORING: Zeitschriftenaufsatz

C2 - 20386874

VL - 81

SP - 719

EP - 726

JO - NERVENARZT

JF - NERVENARZT

SN - 0028-2804

IS - 6

ER -