0:00

This is a 14-year-old child who presented with

0:04

acute onset of myelopathic symptoms.

0:08

I think that this example is a little bit better

0:12

at demonstrating the intramedullary location of

0:16

the arteriovenous malformation.

0:18

than the previous example,

0:20

which was obscured by the fact that the patient

0:22

had bled into the spinal cord and had

0:25

hematomyelia and cord injury. On this example,

0:30

we have a T1-weighted scan which is somewhat

0:32

obscured due to patient motion artifact.

0:35

However,

0:35

if we look at the T2-weighted

0:39

scan and post-contrast scan,

0:42

we are able to identify that the patient indeed

0:44

has a vascular malformation which is located

0:48

within the spinal cord with mild spinal cord

0:50

expansion and that there are draining veins

0:53

in the intradural extramedullary compartment.

0:59

And this is,

1:00

nicely demonstrated also on post-contrast

1:02

enhanced scans where you see the squiggly

1:04

vessels within the spinal cord.

1:09

On a T2-weighted scan,

1:13

you can see the vascular malformation

1:17

within the spinal cord and the blood vessels

1:21

that are associated in the spinal cord.

1:25

The patient has had an area of blood in the

1:31

anterior edge of the spinal cord, but we have the

1:34

vascular malformation within the cord.

1:37

The cord has a little bit of area of gliosis on

1:41

either side of it and then lots of vessels

1:44

around the periphery of the spinal cord.

1:47

So again,

1:47

another example of type two spinal cord

1:52

AVM intramedullary location of the nidus.