Imaging of spinal cord vascular malformations

Abstract Spinal vascular malformations are an important cause of myelopathy in patients. They are often overlooked in the differential diagnosis because of their rarity. It is critical, however, to make a correct diagnosis in the case of spinal vascular malformations, which typically require specific treatment that can reverse or stop the progression of symptoms. Left untreated or treated incorrectly, they can cause further neurological deterioration that may be irreversible. The clinical findings in patients with spinal vascular malformations are often nonspecific and can be confused with the presenting symptoms of more common disease entities such as acquired spinal stenosis or even peripheral vascular disease. The radiologic evaluation of these lesions often shows characteristic findings that will lead to the proper diagnosis or that will at least limit the differential diagnosis and lead to definitive diagnostic testing. This article describes the various radiologic tools available for the evaluation of spinal vascular malformations. It also describes the characteristic radiologic findings of each type of spinal vascular malformation and which modality is best suited for its evaluation. Through the appropriate use and interpretation of imaging techniques, patients with myelopathy caused by a spinal vascular malformation can be accurately diagnosed and treated.