What is the cause of spinal vascular malformation

Spinal vascular malformation is actually caused by rupture and bleeding of malformed blood vessels. Patients often show neuropathic pain or progressive nerve root and spinal cord dysfunction, as well as acute bleeding, combined with other malformation symptoms.

1. Causes

The clinical symptoms of spinal vascular malformations are caused by rupture and bleeding of malformed blood vessels. Because the walls of the malformed blood vessels are thin and the drainage venous pressure is high, especially when complicated by an aneurysm or varicose vein, if there is a sudden increase in arterial blood pressure or obstruction of venous return, the malformed blood vessels are very likely to rupture and bleed. Bleeding may occur in the subarachnoid space of the spinal cord or within the spinal cord. When bleeding forms a hematoma, it causes direct compression and damage to the spinal cord, further aggravating the spinal cord damage.

2. Clinical manifestations

1. Radiculopathy

There is radiating pain in the distribution area of ​​the nerve roots where the lesion is located, such as radiating pain in the neck, back, waist or lower limbs. Changes in body position can induce pain, which can be relieved by rest. Pain may affect more than two nerve root territories.

2. Progressive nerve root and spinal cord dysfunction

It manifests as motor, sensory and sphincter dysfunction in different parts and degrees: weak muscle strength, intermittent claudication, decreased or absent sensation, incontinence, etc. The typical symptom is intermittent claudication. The patient feels muscle weakness and pain after walking a certain distance. The symptoms disappear after resting, but recur after walking a certain distance again. The reason is that the abnormal blood vessels steal blood, causing chronic ischemia of the spinal cord; when exercise occurs, the blood is redistributed and accumulates in the skeletal muscles, which aggravates the ischemia of the spinal cord and produces symptoms.

3. Acute bleeding

Sudden onset of severe radicular pain, quadriplegia or paraplegia; blood may flow back into the skull, causing headache, vomiting or convulsions, and possible disturbance of consciousness. Once a hematoma is formed, direct damage or compression to the spinal cord causes rapid loss of spinal cord function.

4. Combined with other deformities

It is often accompanied by spinal deformities, dorsal skin hemangiomas (nevuses) in the corresponding segments of the lesions, intracranial vascular malformations, aneurysms, and liver or kidney hemangiomas.