Affiliations: [a] The Children's Mercy Hospital, Kansas City, MO, USA | [b] Primary Children's Medical Center, Salt Lake City, UT, USA
Correspondence:
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Corresponding author: Matthew McLaughlin, The Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA. Tel.: +1 816 234 3970; Fax: +1 816 983 6845; E-mail:mjmclaughlin@cmh.edu
Abstract:
PURPOSE: Describe the case of a spinal arteriovenous malformation
(AVM), which represents a rare cause for tetraplegia in the infant
population. TREATMENT: This patient underwent treatment with surgical clipping
of an intradural AVM, intravenous steroids, and inpatient rehabilitation. DISCUSSION: Although AVMs are a congenital vascular malformation,
spinal AVMs are extremely rare with only a few case reports published in the
pediatric literature. Generally AVMs are diagnosed intracranially which
would lead to cerebral infarction; however, in this case, the AVM was in the
cervical spinal cord leading to tetraplegia. With medical and rehabilitation
interventions, the patient's function improved significantly; however,
long-term prognostication remained difficult given the lack of standardized
assessments and the inaccuracy of the American Spinal Injury Association
(ASIA) examination for this age group. CONCLUSION: Spinal AVMs are extremely rare in the pediatric
population; however, with this case the use of surgical intervention helped
prevent further loss of neurologic impairment, and inpatient rehabilitation
served to increase the patient's function. She continued to participate in
outpatient rehabilitation to improve developmental milestones, mobility,
posture, positioning, and upper limb function.
