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Spinal vascular malformations: an historical perspective
Journal article   Open access   Peer reviewed

Spinal vascular malformations: an historical perspective

Perry Black
Neurosurgical focus, v 21(6), E11
15 Dec 2006
DOI: https://doi.org/10.3171/foc.2006.21.6.2
PMID: 17341044
url
https://thejns.org/downloadpdf/journals/neurosurg-focus/21/6/foc.2006.21.6.2.pdfView
Published, Version of Record (VoR) Open
url
https://doi.org/10.3171/foc.2006.21.6.2View
Published, Version of Record (VoR) Open

Abstract

Adolescent Adult Angiography - history Central Nervous System Vascular Malformations - classification Central Nervous System Vascular Malformations - diagnosis Central Nervous System Vascular Malformations - diagnostic imaging Central Nervous System Vascular Malformations - history Central Nervous System Vascular Malformations - pathology Central Nervous System Vascular Malformations - surgery Child Diagnosis, Differential Europe Female Hamartoma - diagnosis Hamartoma - diagnostic imaging Hamartoma - history Hamartoma - pathology Hamartoma - surgery Hemangioma, Cavernous, Central Nervous System - diagnosis Hemangioma, Cavernous, Central Nervous System - diagnostic imaging Hemangioma, Cavernous, Central Nervous System - history Hemangioma, Cavernous, Central Nervous System - pathology Hemangioma, Cavernous, Central Nervous System - surgery History, 19th Century History, 20th Century History, 21st Century Humans Laminectomy Male Neurosurgery - history Neurosurgical Procedures - history Radiology - history Spinal Cord - blood supply Spinal Diseases - diagnosis Spinal Diseases - diagnostic imaging Spinal Diseases - history Spinal Diseases - pathology Spinal Diseases - surgery Spinal Neoplasms - diagnosis Spinal Neoplasms - diagnostic imaging Spinal Neoplasms - history Spinal Neoplasms - pathology Spinal Neoplasms - surgery United States
In this historical perspective, the author identifies three epochs in the development of the concepts and treatment of spinal vascular lesions: 1) early observations (1860s-1912), with the lesions during this time period recognized only at autopsy; 2) the "middle ages" (1912-1960), with surgical intervention sporadic and yielding dismal results; and 3) the modern era (beginning in the 1960s), coincident with parallel dramatic advances in radiology, microsurgical instrumentation, and anesthesiology. These advances resulted in a better understanding of the pathophysiological aspects and angioarchitecture of the lesions. Whereas the nomenclature of the lesions in the past was confusing, a new understanding of these diseases that has emerged during the modern era has permitted refinement of the classification of the lesions as distinct biological entities. Modern diagnostic imaging has enabled identification of patients who may benefit from surgical or embolic occlusion, and treatment has become rationally based. Future progress in the management of spinal vascular lesions may be anticipated, with improvement in noninvasive imaging for early detection of suspected abnormalities. Furthermore, advances in spinal cord neuroprotection may expand the range of future options for surgical or embolic intervention.

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