Spinal Vascular Malformations

A Pediatric Spinal Vascular Malformation (SVM) refers to an abnormal connection between arteries and veins in or around the spinal cord, causing abnormal blood flow that can damage the spinal cord over time. These malformations can be congenital (present at birth) or develop early in childhood, and they may lead to spinal cord compression, paralysis, chronic back pain, and bladder or bowel dysfunction if left untreated. In children, spinal vascular malformations are rare, but when they do occur, they are often more aggressive and symptomatic than in adults. Early diagnosis and microsurgical or endovascular treatment are essential to prevent irreversible neurological damage. In Bangladesh, lack of awareness and limited access to pediatric MRI or spinal angiography often results in misdiagnosis as spinal cord tumors or infections. That’s why Dr. Md. Nafaur Rahman, a leading pediatric neurosurgeon in Bangladesh, is committed to providing cutting-edge care and long-term recovery for children affected by SVMs. 🌍 Pediatric SVMs in Bangladesh – The Reality Despite being rare, pediatric spinal vascular malformations are frequently underdiagnosed or misdiagnosed in Bangladesh due to: ❌ Limited expertise in pediatric spinal disorders 🧠 Inadequate neuroimaging capabilities in district or rural hospitals 🔄 Misinterpretation as spinal tumors, TB, or developmental delay 💸 Financial barriers to MRI spine or DSA (Digital Subtraction Angiography) ⏰ Delayed referral to pediatric neurosurgeons Dr. Nafaur Rahman leads the effort in accurate diagnosis, individualized treatment planning, and surgical precision, backed by a multidisciplinary pediatric neurovascular team in Dhaka. ⚠️ Common Symptoms of Pediatric Spinal Vascular Malformations Spinal vascular malformations can present with a wide range of symptoms depending on their location and the severity of blood flow disturbance. Typical signs in children include: 🦵 Progressive weakness or paralysis in the legs ⚡ Sudden back pain or midline spine discomfort 🧍 Abnormal gait or walking difficulty 🚽 Urinary incontinence or bowel dysfunction 🧒 Growth retardation or scoliosis in chronic cases ⚠️ Sudden neurological deterioration due to hemorrhage or venous congestion “If a child develops unexplained leg weakness or bladder issues, think beyond infection or injury. A spinal vascular malformation may be the hidden cause.” — Dr. Md. Nafaur Rahman 🧬 Types of Pediatric Spinal Vascular Malformations There are several types of SVMs based on the location and nature of the abnormal blood vessels: 🔹 Spinal Arteriovenous Malformation (AVM) Tangle of abnormal arteries and veins in the spinal cord High risk of hemorrhage or spinal cord ischemia 🔹 Spinal Dural Arteriovenous Fistula (DAVF) Abnormal connection between an artery and a vein near the spinal cord’s covering Can cause chronic venous congestion and progressive myelopathy 🔹 Spinal Perimedullary Fistula A more aggressive lesion located directly on the spinal cord’s surface Presents with early neurological deterioration 🔹 Capillary Telangiectasia or Cavernous Malformation Low-flow malformations May cause microbleeds or spinal cord irritation 🏥 Diagnostic Tools & Imaging at NINS and BP Neurocare Centre Dr. Nafaur Rahman ensures a thorough and child-friendly evaluation with the following tools: 🧪 Key Diagnostics: MRI Spine with contrast – First-line tool for identifying edema, abnormal flow voids, or mass effect Spinal MRA (Magnetic Resonance Angiography) – To assess vascular anatomy Digital Subtraction Angiography (DSA) – Gold standard for localization and classification Neurophysiological tests – To monitor spinal cord function during intervention 🛠️ Treatment Options for Spinal Vascular Malformations in Children The management of SVMs is highly specialized and may involve microsurgical removal, endovascular embolization, or a combination. 🔧 Endovascular Embolization: A catheter-based procedure that blocks abnormal blood vessels Minimally invasive and often used as the first-line treatment Especially useful in fistulas and low-risk AVMs 🧠 Microsurgical Resection: Surgical removal of the malformation under a microscope Recommended for inaccessible or partially embolized AVMs Performed with intraoperative neuromonitoring and neuronavigation 🔁 Combined Therapy: In many cases, embolization is followed by surgery for complete cure “In spinal AVMs, timing is everything. Delaying treatment risks permanent spinal cord injury. With early intervention, we can restore function and preserve childhood.” — Dr. Md. Nafaur Rahman 🔁 Post-Treatment Rehabilitation and Follow-Up Recovery depends on the child’s pre-treatment neurological status, the extent of the malformation, and the success of the intervention. 📅 Follow-up includes: Repeat MRI/MRA every 6–12 months Neurological exams to monitor motor and bladder recovery Physical therapy for mobility and strength Urological evaluation for bladder control issues School readiness programs for cognitive and psychosocial reintegration 🚨 Risks of Untreated Pediatric SVMs 🧠 Permanent spinal cord damage and paralysis 💩 Loss of bowel and bladder control ⚡ Severe back pain and deformity 🔁 Recurrent hemorrhages in aggressive lesions 🧑‍🦽 Irreversible neurological disability 👨‍⚕️ Why Choose Dr. Md. Nafaur Rahman for Pediatric SVM Surgery? 🧒 Bangladesh’s leading pediatric neurosurgeon for rare spinal vascular conditions 🧠 Expertise in microsurgical and endovascular hybrid techniques 🏥 Operates at National Institute of Neurosciences (NINS) 🩺 Offers child-centered, minimally invasive interventions 🤝 Provides long-term follow-up and multidisciplinary rehabilitation 📞 Contact for Pediatric SVM Consultation or Surgery Dr. Md. Nafaur Rahman Assistant Professor, Pediatric Neurosurgery, NINS Chief Consultant, Bangladesh Paediatric Neurocare Centre 📱 For Serial/Appointment: 📞 01912988182 | 📞 01607033535 🌐 Website: www.neurosurgeonnafaur.com