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Current Treatment Options in Neurology
Published in: Current Treatment Options in Neurology 6/2012

01-12-2012 | CEREBROVASCULAR DISORDERS (HP ADAMS JR, SECTION EDITOR)

Vascular Diseases of the Spinal Cord: A Review

Authors: Mirjam Rachel Heldner, MD, Marcel Arnold, MD, Krassen Nedeltchev, MD, Jan Gralla, MD, MSc, Jürgen Beck, MD, Urs Fischer, MD, MSc

Published in: Current Treatment Options in Neurology | Issue 6/2012

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Opinion statement

• In acute spinal cord ischemia syndrome (ASCIS), treatment recommendations are derived from data of cerebral ischemic stroke, atherosclerotic vascular disease and acute spinal cord injury. Besides acute management, secondary prevention is of major importance. Pathologies affecting the aorta as well as underlying cerebrovascular conditions should be treated whenever possible.
• ASCIS may occur after aortic surgery, less often after thoracic endovascular aortic repair (TEVAR). Protocols are proposed.
• Acute spinal cord hemorrhage can be treated surgically and/or pharmacologically.
• Symptomatic treatment in patients with a spinal cord lesion is of major importance. Depending on level and extension of the lesion, there is a risk for systemic and neurological complications, which may be life-threatening.
• Each spinal vascular malformation is a unique lesion that needs an individualized treatment algorithm. In case of a symptomatic vascular malformation, endovascular intervention is the primary treatment option.
• Spinal dural Arteriovenous fistula (AVF) may be treated endovascularly or surgically. If preoperative localization of the fistula is possible, surgery is feasible with a low complication rate. In comparison, endovascular approaches are less invasive.
• Spinal AVM are rather treated endovascularly than surgically or in a stepwise multidisciplinary approach.
• Symptomatic and exophytic spinal cavernous angiomas should be treated surgically. Deep spinal cavernous angiomas that are asymptomatic or only show mild symptoms can be observed.
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Metadata
Title
Vascular Diseases of the Spinal Cord: A Review
Authors
Mirjam Rachel Heldner, MD
Marcel Arnold, MD
Krassen Nedeltchev, MD
Jan Gralla, MD, MSc
Jürgen Beck, MD
Urs Fischer, MD, MSc
Publication date
01-12-2012
Publisher
Current Science Inc.
Published in
Current Treatment Options in Neurology / Issue 6/2012
Print ISSN: 1092-8480
Electronic ISSN: 1534-3138
DOI
https://doi.org/10.1007/s11940-012-0190-9

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