Spinal Cord Venous Infarction Presumed to be Caused by a Lumbar Vertebral Body Malformation after Vertebral Complession Fracture

Shinji Tanishima Satoru Fukata

doi:10.4172/2165-7939.1000145

Abstract

We report a case of a 81-year-old woman with a subacute bilateral legs palsy due to venous congestion of the spinal cord caused by an arteriovenous fistula in the first lumbar vertebra which fractured previously. We diagnosed her spinal infarction only by MRI. She recovered from leg palsy at first. So we waited and saw her symptom. But after that leg palsy repeated with short interval and gradually her palsy was getting worse and became completed palsy. We performed selective spinal angiography and found out arteriovenous fistula in first lumbar vertebra fractured previously. We estimated that vertebral fracture might make arteriovenous fistula in vertebral body and this fistula caused venous congestion spinal cord. Spinal cord venous infarctions due to venous congestion with lumbar vertebral body malformation is a very rare. Therefore we delayed to diagnose and this delay caused to permanent neurological deficits.

Highlights

Anterior cord syndrome is the most common type of spinal cord infarction, and most cases are caused by an interruption in the arterial blood circulation
As grey matter signal changes supplied by an artery are clearly observed by magnetic resonance imaging (MRI) in cases of arterial infarction, this disease may be suspected on the basis of imaging findings alone [1,2]
Most previous reports have diagnosed spinal cord venous infarctions on the basis of anatomical examinations of fatal cases. These reports stated that most venous infarctions are caused by thrombosis, but few reports are available on lumbar vertebral body malformation in combination with a spinal cord venous infarction [4]