Work

Analysis of the treatment pathway and causes of delay in a young patient with spinal arteriovenous malformations: A case report

Year: 2025

Type: article

Abstract: Background Spinal arteriovenous malformations (SAVMs) are rare, Early insidious, non-specific symptoms cause diagnostic delay—higher in adolescents—leading to psychological distress, educational interruption, poor prognosis, and more. Timely intervention improves outcomes, but research on young patients’ pre-admission clinical trajectory is limited. Case presentation A 20-year-old male with 1-month lower limb weakness/numbness and sphincter disturbance was diagnosed with SAVMs. Initial low back pain was ignored due to his intense training but symptoms progressed to urinary/defecatory dysfunction. Spinal CT was normal, MRI showed T9-L3 abnormal signals and T8-T12 spinal cord edema. Even with worsening symptoms every day the time from the discovery of the symptoms to the acceptance of the correct treatment was 40 days. Intervention The young man had endovascular embolization (DSA + EMB) at a tertiary hospital. Access to the right common femoral artery was gained via the Seldinger method, delivering embolic agents(N-butyl cyanoacrylate NBCA) into this vessel, control angiography confirmed a significant reduction in both blood flow velocity and volume within the malformed vasculature. Post-rehabilitation, 3-month follow-up showed normal walking, recovered defecation, Urinary Functionand improved neurological function (Aminoff & Logue Scale changed from 7to 0. Conclusion Diagnostic delays stem from atypical symptoms, primary physicians’ limited experience, and poor early screening. Strategies like physician training, optimized diagnostics, and public education are recommended to improve timely SAVM care.

Source: Interdisciplinary Neurosurgery

DOI: 10.1016/j.inat.2025.102159

Authors: Guiying Liu, Lifang Wen, Yanyan Zhang, Dan Zhao, Ling Tang, Xin Guan

Institutions: Beijing University of Chinese Medicine, Capital Medical University, Xuan Wu Hospital of the Capital Medical University

Language: English

Topic: Vascular Malformations Diagnosis and Treatment

Subfield: Neurology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,910