Challenging dogma: report of a spinal cord arteriovenous malformation as an acquired lesion in a pediatric patient

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Spinal cord intramedullary arteriovenous malformations (AVMs) have classically been considered congenital lesions that are present from birth. The reason for this dogmatic principal is the fact that a vast majority of these lesions present in pediatric and young adult patients. Interestingly, while many authors have demonstrated the development of de novo nidus-type brain AVMs, there have been no reported cases of a de novo intramedullary or perimedullary AVM of the spine. In this paper the authors describe what they believe to be the first reported case of a de novo AVM of the spinal cord in a young patient who underwent serial imaging from birth for evaluation of a syrinx. Potential pathophysiological mechanisms for the development of de novo vascular malformations of the spinal cord are discussed.

ABBREVIATIONS AVF = arteriovenous fistula; AVM = arteriovenous malformation; SCAVM = spinal cord AVM.
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Contributor Notes

Correspondence Waleed Brinjikji: Mayo Clinic, Rochester, MN. brinjikji.waleed@mayo.edu.INCLUDE WHEN CITING Published online October 25, 2019; DOI: 10.3171/2019.7.SPINE19253.Disclosures Dr. Patterson reports direct stock ownership in IntraBio; being a consultant for Actelion, Amicus, Novartis, Orphazyme, Shire, and Cerecor; and statistical analysis support from Actelion.
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