Figure 2 Sagittal view of T2 weighted Contrast MRI showing
intramedullary mass at thoracolumbar level
Under general anesthesia, a laminectomy at the D11-L2 level and
exploration was performed by an experienced neurosurgeon. The findings
were a large tortuous vascular channel on the dorsal surface of the
spinal cord and a large tuft of vascular channels (nidus) on the right
side of the dorsal root on the spinal cord at D12-L1 level. Excision of
spinal AVM was done under GA, and AVM nidus was dissected off the pial
surface of the spinal cord. First, the feeding artery was coagulated,
followed by coagulation of the draining vein. Next, a feeding artery
arising from neural foramen was coagulated and cut.
A tissue biopsy from nidus was taken and sent for histopathological
examination, which further confirmed the diagnosis of spinal AV
malformation. Postoperatively she was kept on vancomycin 500mg IV,
fentanyl 50 microgram per hour IV, pregabalin 75 mg PO, amitriptyline,
ondansetron 4 mg IV, labetalol, and thiamine. She was discharged after
12 days of surgery.
She was followed up 6 months later, on May 15, by phone call. There was
mild improvement in the motor function of the patient after the
operation. There were no complications or adverse effects.