Although rare, spinal cord vascular diseases represent a potentially devastating group of conditions that can be challenging to diagnose but rewarding to treat. A keen understanding of when to consider a spinal cord vascular disease, and the treatment options (often requiring a multimodal approach) is essential to achieving optimal patient outcomes.

Spinal arteriovenous malformations (AVMs) are the second most common spinal vascular anomalies after dural arteriovenous fistulas, accounting for 15% of all spinal vascular malformations. Typically, the anterior and posterior spinal arteries supply arterial blood to intramedullary or perimedullary aberrant foci or cavities, and then drain into a spinal vein.

Knowledge of the associated conditions, clinical manifestations, and current monitoring techniques may allow for rapid diagnosis of spinal cord ischemia, when therapies can be applied with the greatest likelihood of success. This section will review the clinical manifestations, imaging studies, and treatment options of this potentially devastating spinal cord disorder.