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Hematomyelia as a consequence of arteriovenous malformation disruption

https://doi.org/10.30629/2658-7947-2021-26-3-40-45

Abstract

The most common causes of hematomyelia are vascular anomalies, arteriovenous malformations, vasculitis, traumas, and conditions leading to hypocoagulation. In the presented clinical observations, hematomyelia developed against the background of anticoagulant administration and disruption of arteriovenous malformation. The disease manifests itself acutely, and the clinical picture depends on the level of spinal cord injury. Diagnosis of hematomyelia is straightforward and is based on neuroimaging by means of magnetic resonance imaging (MRI). There is no eff ective pathogenetic pharmacological therapy for hematomyelia; treatment is aimed at complications prevention. Taking in consideration the presence of a disabling neurologic impairment, this category of patients experiences an increased risk of venous thromboembolic disorders development, including fatal pulmonary embolism. In this regard, early measures are needed to prevent the development of venous thrombosis. The straightforward procedure of treatment is neurosurgical intervention in order to eliminate the source of bleeding and prevent repeated intramedullary hemorrhages. Timely diagnosis of hematomyelia followed by neurosurgical intervention leads to a favorable outcome of the disease, a decrease in mortality and disability.

About the Authors

G. R. Ramazanov
Research Institute of Emergency Medicine named after Sklifosovsky N.V. Healthcare Department
Russian Federation

Moscow



A. E. Talypov
Research Institute of Emergency Medicine named after Sklifosovsky N.V. Healthcare Department
Russian Federation

Moscow



L. Kh.-B. Akhmatkhanova
Research Institute of Emergency Medicine named after Sklifosovsky N.V. Healthcare Department
Russian Federation

Moscow



A. A. Kanibolotsky
Research Institute of Emergency Medicine named after Sklifosovsky N.V. Healthcare Department
Russian Federation

Moscow



S. S. Petrikov
Research Institute of Emergency Medicine named after Sklifosovsky N.V. Healthcare Department
Russian Federation

Moscow



References

1. Qureshi A.I., Afzal M.R., Suri M.F.K. A Population-Based Study of the Incidence of Acute Spinal Cord Infarction. J. Vasc. Interv. Neurol. 2017;9(4):44–48. PMID: 28702119

2. Scott T.F. Spinal Cord Infarction. 2018. URL: https://emedicine.medscape.com/article/1164217-overview

3. Akpınar A., Celik B., Canbek I., Karavelioğlu E. Acute Paraplegia due to Thoracic Hematomyelia. Case Rep. Neurol. Med. 2016;(2016):3138917. https://doi.org/10.1155/2016/3138917

4. Chao C.-H., Tsai T.-H., Huang T.-Y., Lee K.-S., Hwang S.-L. Idiopathic spontaneous intraspinal intramedullary hemorrhage: a report of two cases and literature review. Clin. Neurol. Neurosurg. 2013;115(7):1134–1136. https://doi.org/10.1016/j.clineuro.2012.09.004

5. Hwang J.H., Sung J.K., Hwang S.K., Hamm I.S., Park Y.M., Kim S.L. Spontaneous hemotomyelia. Journal of Korean Neurosurgical Society. 2000;29(3):411–419. https://doi.org/10.1155/2016/3138917

6. Wong K.M., Tan M.M.L. Cervical hematomyelia after traditional Chinese massage: a case report. Japanese Journal of Radiology. 2012;30(5):450–452. https://doi.org/10.1007/s11604-012-0064-9

7. Karavelis A., Foroglou G., Petsanas A., Zarampoukas T. Spinal cord dysfunction caused by non-traumatic hematomyelia. Spinal Cord. 1996;34(5):268–271. https://doi.org/10.1038/sc.1996.48

8. Clark J.M.P. Traumatic haematomyelia from rapture of intramedullary angioma. The Journal of bone and joint surgery. 1954;36(3):418–422. https://doi.org/10.1302/0301-620X.36B3.418

9. Jellinger K. Vascular malformations of the central nervous system: a morphologic overview. Neurosurg. Rev. 1986;9(3):177–216. https://doi.org/10.1007/BF01743136

10. Lee D.H., Choi Y.H. Spontaneous intramedullary hematoma initially mimicking myocardial infarction. Am. J. Emerg Med. 2014;32(10):1294.e3 — 1294.e4. https://doi.org/10.1016/j.ajem.2014.03.002

11. Breadley W.G., Daroff R.B., Fenichel G., Jankovic J. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa, USA: Heinemann; 2004.

12. Kaaravelis A., Foroglou G., Petsanas A., Zarapoukas T. Spinal cord dysfunction caused by non-traumatic hematomyelia. Spinal Cord. 1996;34(5):268–271. https://doi.org/10.1038/sc.1996.48

13. Hunderfund A.N.L., Wijdicks E.F.M. Intramedullary spinal cord hemorrhage (hematomyelia). Reviews in Neurological Diseases. 2009;6(2):E54–E61. PMID: 19587631

14. Toda H., Okamoto T., Nishida N., Yuba Y., Iwasaki K. Idiopathic hematomyelia as a rare cause of epiconus syndrome. Clin. Neurol. Neurosurg. 2014;125:75–77. https://doi.org/10.1016/j.clineuro.2014.07.023

15. Saliou G., Tej A., Theaudin M., Tardieu M., Ozanne A., Sachet M., Ducreux D., Deiva K. Risk factors of hematomy- elia recurrence and clinical outcome in children with intradural spinal cord arteriovenous malformations. AJNR Am. J. Neuroradiol. 2014;35(7):1440–1446. https://doi.org/10.3174/ajnr.A3888

16. Niu X., Liu H., Li J. Intramedullary hemorrhage from a thoracic dural arteriovenous fistula. Neurology. 2020. [Published Ahead of Print on September 16, 2020] https://doi.org/10.1212/WNL.000000000010881 URL: https://n.neurology.org/content/neurology/early/2020/09/16/WNL.000000000010881.full.pdf [Дата обращения 21 октября 2020]

17. Singh B., Behari S., Jaiswal A.K., Sahu R.N., Mehrotra A., Mohan B.M., Phadke R.V. Spinal arteriovenous malformations: Is surgery indicated? Asian J. Neurosurg. 2016;11(2):134–142. https://doi.org/10.4103/1793-5482.177663

18. Baglin T. What happens after venous thromboembolism? J. Thromb. Haemost. 2009;7(Suppl. 1):287–290. https://doi.org/10.1111/j.1538-7836.2009.03409.x


Review

For citations:


Ramazanov G.R., Talypov A.E., Akhmatkhanova L.Kh., Kanibolotsky A.A., Petrikov S.S. Hematomyelia as a consequence of arteriovenous malformation disruption. Russian neurological journal. 2021;26(3):40-45. (In Russ.) https://doi.org/10.30629/2658-7947-2021-26-3-40-45

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ISSN 2658-7947 (Print)
ISSN 2686-7192 (Online)