Intradural spinal arteriovenous malformation in a 13-month-old female: A case report

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.