Present address: Department of Neurology, Kyoto Prefectural University of Medicine, Kajiicho 465, Kamigyo-ku, Kyoto 602-8566, Japan.
Venous congestive myelopathy: Three autopsy cases showing a variety of clinicopathologic features
Version of Record online: 3 JAN 2008
© 2007 Japanese Society of Neuropathology
Volume 28, Issue 3, pages 303–308, June 2008
How to Cite
Matsuo, K., Kakita, A., Ishizu, N., Endo, K., Watanabe, Y., Morita, T. and Takahashi, H. (2008), Venous congestive myelopathy: Three autopsy cases showing a variety of clinicopathologic features. Neuropathology, 28: 303–308. doi: 10.1111/j.1440-1789.2007.00880.x
- Issue online: 3 JAN 2008
- Version of Record online: 3 JAN 2008
- Received 13 July 2007; revised and accepted 1 November 2007.
- angiodysgenetic necrotizing myelopathy;
- Foix–Alajouanine syndrome;
- spinal cord;
We describe three patients with progressive myelopathy, in whom autopsy revealed spinal cord pathology compatible with that of venous congestive myelopathy (VCM) associated with dural arteriovenous fistula (AVF), formerly known as angiodysgenetic necrotizing myelopathy (Foix–Alajournine syndrome). In these three patients, common symptoms were gait disturbance and sensory disturbance of the extremities, and these symptoms slowly worsened. The clinical diagnoses varied and included spinal cord intramedullary tumor, cervical spondylosis and multiple sclerosis. At autopsy, all the patients showed enlarged, tortuous venous vessels on the dorsal surfaces of the spinal cord at the affected levels. In the affected spinal cord parenchyma, necrotic lesions manifested by various degrees of neuronal loss and gliosis, with increased numbers of hyalinized vessels, were evident. The presence or absence of associated spinal dural AVF could not be identified histopathologically. Even with the help of modern neurological examination methods, early and accurate clinical diagnosis of VCM is sometimes difficult. When encountering patients with progressive myelopathy, VCM, although recognized as rare, should be considered as an important differential diagnosis.